Ichmelyan Albert Misakovich (Candidate of Medical Sciences, Associate Professor
State Educational Institution of Higher Professional Education Ulyanovsk State University
)
Bogdasarov Azat Yuryevich (Doctor of Medical Sciences, Professor
State Educational Institution of Higher Professional Education Ulyanovsk State University
)
Davidyan Liana Yuryevna (Doctor of Medical Sciences, Professor
State Educational Institution of Higher Professional Education Ulyanovsk State University
)
Bogdasarova Regina Azatovna (Postgraduate Student, State Educational Institution of Higher Professional Education Ulyanovsk State University)
| |
The effectiveness of assisted reproductive technologies (ART) in patients of advanced reproductive age with idiopathic infertility remains low, reaching only 12-18% live births per embryo transfer in the 38-42 year age cohort [1,2]. The aim of this observational cohort study was to identify specific clinical and anamnestic patterns associated with previous IVF failure to support differentiated preconception care strategies. The study included 239 women aged 35 to 45 years (mean age 37.4 ± 4.1 years) with idiopathic infertility and one previous IVF failure. The use of nonparametric statistical methods allowed us to identify two discrete clinical phenotypes. The main phenotype (n=115) was characterized by a significantly higher frequency of background cervical diseases in the anamnesis (23.5% vs. 8.1%; χ²=10.52, p=0.001), chronic dermatoses (16.5% vs. 4.0%; χ²=8.96, p=0.003), as well as non-alcoholic fatty liver disease (NAFLD) diagnosed during examination (14.8% vs. 2.4%; χ²=11.93, p=0.0006) and current dermatological diseases (14.8% vs. 2.4%; χ²=11.93, p=0.0006). The second phenotype (comparison group, n=124) was characterized by a significantly higher frequency of a history of functional ovarian cysts (20.2% vs. 9.6%; χ²=5.92, p=0.015). These data demonstrate clinical heterogeneity in the population of women with unsuccessful IVF experiences. The comorbidity of the first phenotype is interpreted as a clinical manifestation of latent low-grade systemic inflammation, oxidative stress, and endothelial dysfunction, pathogenetically associated with dysregulation of the melatoninergic system. The study results substantiate the need to move from standardized protocols to personalized preconception care focused on targeted metabolic, antioxidant, and anti-inflammatory correction in patients with an identified unfavorable phenotype.
Keywords:assisted reproductive technologies, IVF failures, idiopathic infertility, advanced reproductive age, personalized medicine, preconception preparation, oxidative stress, melatonin, non-alcoholic fatty liver disease, clinical phenotypes.
|
|
| |
|
Read the full article …
|
Citation link:
Ichmelyan A. M., Bogdasarov A. Y., Davidyan L. Y., Bogdasarova R. A. CLINICAL AND PATHOGENETIC RATIONALE FOR INDIVIDUALIZED PRECONCEPTION CARE IN WOMEN OF ADVANCED REPRODUCTIVE AGE WITH IDIOPATHIC INFERTILITY AND PREVIOUS IVF FAILURES // Современная наука: актуальные проблемы теории и практики. Серия: Естественные и Технические Науки. -2026. -№02/2. -С. 170-175 DOI 10.37882/2223-2966.2026.02-2.13 |
|
|
