METHOD FOR STIMULATING THE GROWTH OF FOLLICLES IN THE PROGRAM OF IN VITRO FERTILIZATION IN PATIENTS WITH INFERTILITY AND 'POOR RESPONSE TO STIMULATION'

摘要

FIELD: medicine.;SUBSTANCE: invention relates to medicine, particularly to obstetrics and gynecology, and can be used for stimulating the growth of follicles in the program of in vitro fertilization in patients with infertility and "poor response to stimulation". For this purpose, two consecutive ovarian stimulations are carried out, wherein clomiphene is administered at a dose of 100 mg per day for 5 days to stimulate the ovaries in the 1st cycle and follitropinum alfa is simultaneously administrated at a dose of 150 ME per day for 5 days; if on the 6th day follicles reach a diameter of 12–13 mm, the follitropinum alfa dose remains the same, if follicles do not reach said diameter – follitropinum alfa dose is increased to 225 ME per day until follicles reach a diameter of 17–19 mm, after which on the 10th day, the administration of follitropinum alpha is stopped and an ovulation trigger of triptorelin is administered at a dose of 0.2 mg, after 36 hours, transvaginal puncture of follicles is performed with vitrification of eggs is performed, dydrogesterone is administered orally at a dose of 30 mg per day for 7 days and estradiol is administrated transdermally at a dose of 2 mg per day for 10 days; 10th day after the puncture, the 2nd stimulation cycle begins with the administration of follitropinum alfa at a dose of 225 ME per day for 9 days, on the 10th day an ovulation trigger Ovitrelle is subcutaneously administered at a dose of 6,500 ME, then after 36 hours transvaginal puncture of follicles is carried out with prescription of micronized progesterone at a dose of 600 mg per day before the result from a pregnancy test, eggs, obtained in the 1st cycle of stimulation are thawed, the single fertilization of eggs obtained in two cycles of stimulation and the embryo cultivation are performed, and for the synchronization of follicles before the stimulation of their growth, estradiol valerate is prescribed at a dose of 4 mg per day from the 21st day of the menstrual cycle to the 2nd day of the menstrual cycle before the 1st cycle of stimulation, and from the 1st day after the puncture of follicles to the 1st day of the menstrual cycle before the 2nd stimulation cycle.;EFFECT: method provides an increased number of obtained high-quality eggs, which results in increased frequency of pregnancy in IVF programs.;1 cl, 3 dwg