THERAPEUTIC OPTIONS FOR PRE-GRAVIDARY TRAINING IN WOMEN WITH A HISTORY OF COMBINED INFERTILITY

The objective: to substantiate and evaluate the improvement of pre-gravida preparation in women with a history of combined infertility factors. Materials and methods. We examined 102 women who were diagnosed with two factors of infertility simultaneously – infertility of tubal origin and infertility associated with anovulation caused by hyperprolactinemia and polycystic ovary syndrome. All patients were divided into groups according to the three-month pre-gravida preparation regimen: the 1st group (52 women) received basic pre-gravida preparation (dydrogesterone, folic acid, metformin) in combination with diet; the 2d group 2 (50 patients) – an improved scheme of pre-gravida preparation (dydrogesterone, methyl tetrahydrofolate, potassium iodide, vitamin D3, a complex of myo-inositol and D-chiro-inositol) in combination with diet. The reliability of relative values was evaluated by the Fisher angular transformation method. Results. In women of the 1st group the number of cases of gestational diabetes (30.8 %) was slightly higher than in patients of the 2nd group (20.0 %), the frequency of fetal macrosomia was significantly higher (19.2 % and 10.0 % persons, respectively). The incidence of early miscarriage in persons of the 2d group was significantly lower (40.0 %) than in the 1st group (69.2 %), the risk of late miscarriage was twice lower (14.0 % and 26.9 %, respectively). Conclusions. The proposed complex of pre-gravida preparation in the women with a combined form of infertility (tubal infertility and infertility associated with anovulation), which includes inositol, contributes to a greater reduction in the incidence of obstetric and perinatal complications