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DOI 10.1080/09513590.2018.1490715

Медицинская библиотека · Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology · 2018

Endometrium receptivity in premature ovarian insufficiency - how to improve fertility rate and predict diseases?

Vujović Svetlana, Ivovic Miomira, Tančić-Gajić Milina, Marina Ljiljana, Ljubic Aleksandar, Dragojević-Dikić Svetlana, Genazzani Andrea Ricardo

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Аннотация

More empathized approach is required and is obligatory to women with premature ovarian insufficiency (POI) interested for pregnancy. In order to improve fertility rate in POI patients our suggestions would be: (1) To decrease FSH value to 10-15 IU/L by increasing estrogen. Oocyte donation can be suggested after a minimum of six month interval from FSH between 10-15 IU/L and when no dominant follicles are found. (2) To perform oral glucose tolerance test (OGTT). Insulin sensitizing agents has to be included, when indicated, 3-6 month before pregnancy. (3) TSH has to be 1-2.5 mM/L during 3-6 months before pregnancy. (4) Tests for thrombophyllia (Leiden V, FII, MTHFR, PAI) have to be obligatory. They are less expensive than those repeated in vitro fertilizations. Therapy has to be included according to the indications. (5) In order to regulate disturbed immune response in POI patients with endometriosis oral contraceptive therapy is needed for atleast six months prior to the pregnancy. (5) Encourage the patients and advice them about healthy life style and eating habits. (6) Add other drugs, when they are indicated. Complex interplay between endocrine, immunological, haematological, and psychological factors are very often underdetected in POI patients. It is very important to find out the real time for oocyte donation after correcting all the disturbances, improving endometrium receptivity and reaching women's acceptable psychological status. Untreated disturbances induce cardiovascular diseases, diabetes mellitus, thyroid diseases, coagulopathioes etc.

Для цитирования: Vujović Svetlana, Ivovic Miomira, Tančić-Gajić Milina, Marina Ljiljana, Ljubic Aleksandar, Dragojević-Dikić Svetlana, Genazzani Andrea Ricardo. Endometrium receptivity in premature ovarian insufficiency - how to improve fertility rate and predict diseases?. Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology. 2018. DOI: 10.1080/09513590.2018.1490715.

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