Morphological features of the state of fetoplacental complex in women with early preterm birth after assisted reproductive technologies

2016 ◽  
pp. 79-81
Author(s):  
A.S. Mandrykova ◽  
Keyword(s):  
Preterm Birth ◽  
Preterm Delivery ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Main Group ◽  
Fetal Membranes ◽  
Control Group ◽  
Premature Rupture ◽  
Fetoplacental Complex ◽  
Early Preterm Birth

The objective: the study of morphofunctional changes of the fetoplacental complex at 28–33 weeks of gestation in women with early preterm delivery after the application of ART. Patients and methods. We have examined 130 patients whose pregnancy occurred after the use of ART. This is the woman who gave birth at 28–33 weeks of gestation. Of these, 80 women had early premature births in the background premature rupture of fetal membranes, 50 – patients with early preterm delivery and timely rupture of fetal membranes (control group 2). The main group included 4 groups of 20 women with regard to the duration of anhydrous interval: 1.1 – anhydrous interval 5–6 hours (main group 1); 1.2 – anhydrous span 24 hours; 1.3 – anhydrous interval 45–48 hours; 1.4 – anhydrous period 5 days after PRFM. Results. Thus, the results of the research indicate that the main cause of early preterm birth in women after using ART are structural dezorhanization changes of collagen fibers of the connective tissue amnion and chorionic which lead to the appearance of microscopic defects – delamination its surface, causing premature rupture of fetal membranes the launch stage localized focal immediate type hypersensitivity reactions and restructuring epithelial cell membranes. Neutrophil macrophage properties in this case reduced and programmed to perform a cycle of incomplete phagocytosis, which increases the synthesis of inflammatory cytokines in the area of rupture of fetal membranes. Сonclusion. Reduced activity of neutrophils increases the effect of abuse and cytokine balance in favor predictor of early spontaneous labor at 28-33 weeks of gestation. Key words: morphological changes of the fetoplacental complex, early preterm birth, expectant tactics of childbirth.

scholarly journals Optimizing Pregnancy Management in Women with Infertility of Endocrine Origin: Clinical Course of Pregnancy after the Use of Assisted Reproductive Technologies and Delivery Outcomes

Doctor Ru ◽  
2020 ◽  
Vol 19 (8) ◽  
pp. 14-19
Author(s):  
S.V. Barinov ◽  
◽  
O.V. Ostrovskaya ◽  
I.V. Shamina ◽  
Yu.I. Tirskaya ◽  
...  
Keyword(s):  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Main Group ◽  
Comprehensive Approach ◽  
Control Group ◽  
Delivery Outcomes ◽  
Group I ◽  
Study Results ◽  
Group Ii ◽  
Micronized Progesterone

Study Objective: To optimize pregnancy management and improve delivery outcomes in women with infertility of endocrine origin after the use of assisted reproductive technologies (ART). Study Design: This was an analytical prospective study. Materials and Methods: One hundred and twenty patients with singleton pregnancy were observed: 74 women with infertility of endocrine origin who had undergone in vitro fertilization (IVF) (Group I) and 46 women who became pregnant spontaneously (Group II). The main group (Group I) was divided into subgroup IA (n = 44), in which a comprehensive approach to pregnancy was applied (obstetric pessary and micronized progesterone), and subgroup IB (n = 30) consisting of patients for whom micronized progesterone alone was used. Study Results: Groups I and II differed significantly in miscarriage risk rates: 60.8% and 30.4%, respectively. This complication was most often observed in subgroup IB (80.0%), 2.6 times more often than in Group II (χ2 = 5.700; p = 0,029). There were also statistically significant differences between the groups in the rate of preterm delivery (PD), which was 5.6 times higher in the main group than in the control group (24.3% vs. 4.3%, χ2 = 4.915; p = 0.027). The greatest difference from the control group (9.3 times higher rate) was observed in subgroup IB (χ2 = 10.156; p = 0.004). Conclusion: A comprehensive approach makes it possible to prolong pregnancy, reduce rates of PD by a factor of 2.9 and achieve full-term pregnancies in 86.4% of cases. Keywords: pregnancy, IVF, ART, obstetric complications, perinatal outcomes, Arabin pessary.

scholarly journals PSYCHOEMOTIONAL CHARACTERISTICS OF PREGNANT WOMEN AS A RESULT OF THE ASSISTED REPRODUCTIVE TECHNOLOGIES APPLICATION

2019 ◽  
pp. 42-51
Author(s):  
Antonina Kotenok ◽  
Liliya Vygivska ◽  
Іgor Maidannyk ◽  
Viktor Оleshko
Keyword(s):  
Pregnant Women ◽  
Emotional State ◽  
Assisted Reproductive Technologies ◽  
Study Groups ◽  
Reproductive Technologies ◽  
Main Group ◽  
Control Group ◽  
Male Factor ◽  
Reactive Anxiety ◽  
Personal Anxiety

                                  The issue of preserving the reproductive health of the nation in Ukraine is very acute. The psycho-emotional state of a woman is of particular importance for the prolongation of pregnancy and the normal course of labor. Violation of adaptive mechanisms which are aimed at restructuring the functional systems of the body during pregnancy and on the eve of childbirth, as well as the state of chronic stress contribute to the increase in the of obstetric and perinatal complications frequency and have an adverse effect on the course of pregnancy. The aim of the reaserch was to study the dynamics of psycho-emotional state features in pregnant women after assisted reproductive technologies (ART) application in order to improve the tactics of antenatal surveillance. To achieve this goal, 299 pregnant women were comprehensively examined in the dynamics of prospective observation, which were distributed as follows – the main group included 249 women whose pregnancy occurred as a result of the ART application. The control group consisted of 50 pregnant women with spontaneous pregnancy and its physiological course, which were registered for pregnancy at 6-8 weeks. The women of main group whose pregnancy occurred as a result of ART application were divided into three groups, depending on the factor that caused infertility. The first group included 94 women with tubal-peritoneal factor of infertility, the second group was formed by 87 women with endocrine factor of infertility, the third group included 68 women whose infertility was caused by the male factor. Pregnant women of the study groups by age, marital and social status, place of residence were representative, which allowed further to judge the differences caused by etiological factors of infertility. In order to determine the psycho-emotional state of pregnant women in the study groups in the screening mode, a clinical interview was conducted by filling out questionnaires that contained the constituent questions of the STAI tests in the modification of Yu. L. Khanin and the "Pregnant Attitude Test" by the method of I. V. Dobryakov. The obtained test results indicate that the average score of reactive anxiety in pregnant women of the main group exceeded the same indicator of the control group and was: 49 - pregnant women with tubal-peritoneal type of infertility, 56 - pregnant women with endocrine type of infertility, 44 - pregnant women with male factor of infertility, 24 - control group. According to the results of testing, a significant difference was revealed in the indicators of personal anxiety. The values of indicators of personal anxiety were: 51 - pregnant women with tubal-peritoneal type of infertility, 54 - pregnant women with endocrine type of infertility, 31  -pregnant women with male factor of infertility, 31 - control group. Low level of personal anxiety was observed in 26 (27,6%) pregnant women of I group, 29 (33,3%) pregnant women of II group, which is significantly less in comparison with the indicator of pregnant women of the control group – 33 (66,0%) and III group - 33 (48,5%) (p < 0,05). Moderate type of personal anxiety was observed in 46 (48.9%) pregnant women of group and 40 (45.9%) pregnant women of II group compared to the indicator of the control group – 11 (22, 0%) (p < 0,05). Moderate type of personal anxiety was determined in 25 (36,7%) cases in pregnant women of III group and did not differ significantly from the indicators of I, II and control groups (p > 0,05). A high level of personal anxiety was observed in 22 (23,5%) pregnant women of group I, 18 (20,8%) pregnant women of group II, which is significantly higher in comparison with the indicator of pregnant women of the control group – 6 (12,0%) (p < 0,05). Thus, the study of the psycho-emotional state of pregnant women after the application of ART deviations in the level of personal and reactive anxiety and pathological types of gestational dominant, which are inherent in pregnant women of the main group. Taking into account the above, we consider it appropriate to involve a psychologist to work with the examined pregnant women in order to correct the identified abnormalities.

Risk factors of early preterm labor in single-pregnant women after assisted reproductive technologies

2018 ◽  
pp. 128-131
Author(s):  
A.S. Mandrykova ◽  
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Preterm Labor ◽  
Assisted Reproductive Technologies ◽  
Fertility Restoration ◽  
Reproductive Technologies ◽  
Control Group ◽  
Premature Rupture ◽  
Group I ◽  
Prophylactic Measures

The objective: determination of risk factors of early preterm labor in single-pregnant women after ART on the basis of clinical and anamnestic data. Materials and methods. We study of 130 single-pregnancy pregnancies among the contingent of women with restored fertility after the use of therapeutic ART programs, which ended with early preterm labor. Group I consisted of 50 pregnant women with premature rupture of the membranes for which the tactics of pregnancy with were born by natural way. The second group consisted of 30 pregnant women with premature rupture of the membranes, who carried out general medical and prophylactic measures in accordance with the clinical protocols in accordance with the orders of the Ministry of Health of Ukraine. The control group (GC) has formed 50 pregnant women with early preterm labor with unbroken integrity of the membranes. Results. The retrospective analysis of the methods of fertility restoration in women who were included in the study, carried out by us, indicates the probable relationship of risk of early preterm labor with the ICSI method. The obtained data testify that pregnancy 42.5% of women of the main group, who was chosen ICSI technique ended with early preterm labor. In the contingent of patients whose pregnancy came with IVF, the percentage early preterm labor was 37.5 (р<0.05). The obtained results of researches testify to increase of risks early preterm labor (22.1–29.7%) in patients with chronic inflammatory diseases of the urinary system, which had a latent course. Conclusions. Among the reliable factors of early preterm labor risk, it is necessary to note the high frequency of intrauterine manipulations of diagnostic and therapeutic nature in the use of ART, which results in receptor dysfunction of the endometrium. Key words: risk factors of early preterm labor, assistive reproductive technologies, ICSI, IVF, premature rupture of the membranes, dysfunction of the endometrium.

Features of gene expression of Toll-like receptors in the placenta and fetal membranes during full-term pregnancy, complicated by premature rupture of membrane

2021 ◽  
Vol 19 (2) ◽  
pp. 55-60
Author(s):  
M. A. KAGANOVA ◽  
Keyword(s):  
Mrna Expression ◽  
Molecular Genetic ◽  
Main Group ◽  
Full Term ◽  
Fetal Membranes ◽  
Control Group ◽  
Term Pregnancy ◽  
Premature Rupture ◽  
Tlr2 Expression ◽  
Reverse Transcription Pcr

The purpose — to assess the level of mRNA expression of TLR2, TLR4, TLR7 genes by the placenta and fetal membranes during full-term physiological pregnancy complicated by premature rupture of the membranes (tPROM). Material and methods. The placental and fetal membranes’ samples were collected during cesarean section to assess the level of mRNA expression of TLR2, TLR4, TLR7 genes in 35 women with full-term pregnancy in City Clinical Hospital No. 1 named after N.I. Pirogov (Samara). The main group consisted of 20 pregnant women with tPROM, 15 women were included in the control group (without tPROM or the onset of labor). The level of mRNA expression of the TLR2, TLR4, TLR7 genes was determined by the method of reverse transcription PCR in real time (RT-PCR) in the laboratory of molecular genetic methods of DNA-Technology LLC, using a Proba NK set of reagents. Results. The level of TLR2 expression in the fetal membranes in the main group was 1,87 times higher than in the control group, of TLR4 — 0,69 times lower and of TLR7 — 1,57 times higher. In the placenta, the expression of mRNA TLR2, TLR4, TLR7 genes did not differ. When compared by loci, a significant increase in TLR7 expression in the placenta was noted compared to the fetal membranes. Conclusion. The expression of mRNA TLR2 and TLR7 was increased with PROM in the fetal membranes, while the placenta remained intact and apparently did not participate in the pathogenesis of PROM, but has a higher level of placental TLR7 in both groups, which is apparently associated with more intense antigenic viral stimulation of placental tissues during pregnancy compared with the membranes.

scholarly journals Features of Bio Energetic Metabolism in Children Born after Assisted Reproductive Technologies

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Synenko V.V ◽  
Stoieva T.V ◽  
Bratkova L.B ◽  
Prokhorova S.V ◽  
Fedin M.V
Keyword(s):  
Assisted Reproductive Technologies ◽  
Age Groups ◽  
Allergic Diseases ◽  
Reproductive Technologies ◽  
Physical Development ◽  
Main Group ◽  
Control Group ◽  
First Year ◽  
Mitochondrial Enzymes ◽  
Energetic Metabolism

The features of the functioning of key enzymes of bio energetic metabolism in children born with the application of ART at different age periods. A cytochemical analysis of the activity of key mitochondrial enzymes was performed: succinate dehydrogenase (SDH), α- lycerophosphate dehydrogenase and α-GPDH. The material for the analysis was the buccal epithelium. The material was collected by scraping the epithelium from the inner surface of the cheek. The examined children were representatively distributed into age groups: 1st group - children of the first year old (38 children of the main and 20 children of the control group), 2nd group - from 1 to 3 years old (52 children of the main group and 20 children of the control group), 3rd group - from 4 to 7 years old (46 children of the main group and 20 children of the control group). The average age was 2.7 ± 1.9 years. Conclusion: The study of the activity of mitochondrial enzymes SDH and α-GPDH revealed the most pronounced deviations in the functioning of SDH in the group of children from 1 to 3 years old, which was associated with delayed physical development, allergic diseases, prematurity and diseases of the cardiovascular system. A decrease in the concentration of the enzyme GPDH was most expressed in the older group of children from 4 to 7 years old, and was associated with delayed physical development, Broncho-pulmonary diseases, prematurity, and diseases of the digestive system.

scholarly journals EVALUATION OF HORMONAL ASPECTS BY CERVICAL INSUFFICIENCY IN WOMEN WITH HISTORY OF INFERTILITY

2020 ◽  
Vol 20 (2) ◽  
pp. 76-79
Author(s):  
O.M. Perkhulyn
Keyword(s):  
Blood Serum ◽  
Pregnant Women ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Main Group ◽  
The Body ◽  
Control Group ◽  
Cervical Insufficiency ◽  
The Past ◽  
History Of

Introduction. Today, the frequency of infertility is increasing worldwide. Infertility, associated with anovulation, is especially challenging for the medical correction especially. The leading aspect of this problem is hormonal disorders in the body of a woman. The aim of this study was to assess the level of estradiol and progesterone in the blood serum of pregnant women with cervical insufficiency and infertility associated with anovulation in the history. Materials and methods. The main group included 30 pregnant women with the II trimester of pregnancy, who had cervical insufficiency and infertility associated with anovulation in the past medical history. They got pregnant after assisted reproductive technologies. The control group included 30 pregnant women without cervical insufficiency and with physiological gestation. Estradiol and progesterone levels in blood serum were determined at 20-22 and 30-32 weeks of gestation. Results. The average age of the women in the basic group was statistically higher relative to the control one – 31.30±1.16 and 27.30±0.92 years, respectively (p=0.02). There was no difference in the number of pregnancies in women between both groups. In the main group, 73.33% of the persons were primagravida, 10.00 % of patients had two pregnancies, and 16.67 % - three pregnancies. 56.67 % of the women in the control group were primagravida, 26.67 % had two pregnancies, 16.66 % - three pregnancies. Although primaparas predominated in both groups, the number of such women was in 1.47 times higher in the main group (93.33 %) than in control (63.33 % of patients; χ2=6.28, p=0.01); 6.67 % and 26.67 % women had two labors respectively and 10.00 % of healthy patients - three labors. The concentration of estradiol at the 20-22 and 30-32 weeks of pregnancy in women of the main group almost corresponded to physiological parameters. However, the progesterone level in women with cervical insufficiency and a history of infertility was by 13.44 % lower than in healthy pregnant women at 20-22 weeks, and by 17.02% at 30-32 weeks (p=0.003). Conclusions. In pregnant women with cervical insufficiency and infertility associated with anovulation, the level of estradiol in the II and III trimesters of gestation mainly corresponds to the level of physiological pregnancy. However, they have the decrease in progesterone concentration in the III trimester of pregnancy relative to healthy pregnant women (p<0.003).

scholarly journals Possibilities of antenatal pathology diagnostics in women after assisted reproductive technologies

2021 ◽  
Vol 8 (3) ◽  
pp. 149-154
Author(s):  
Tat’yana A. Kamaeva
Keyword(s):  
Pregnant Women ◽  
Assisted Reproductive Technologies ◽  
Negative Impact ◽  
Peripheral Resistance ◽  
Reproductive Technologies ◽  
Main Group ◽  
Placental Insufficiency ◽  
Diagnostic Methods ◽  
Control Group ◽  
Timely Diagnosis

PURPOSE: improving the efficiency of diagnosis of placental insufficiency using modern diagnostic methods. MATERIALS AND METHODS: The analysis of individual cards, analysis of the gynecological history and somatic morbidity of 426 pregnant women who did not have somatic pathologies and underwent screenings in accordance with the current regulations were performed. The main group of them consisted of 290 women, who showed signs of chronic placental insufficiency at different stages of pregnancy. The control group consisted of 136 women who had no signs of placental insufficiency throughout their pregnancy. RESULTS: It was revealed that the main reasons for the development of chronic placental insufficiency of the main group are preeclampsia (68.4%), the threat of termination of pregnancy (34.7%), burdened obstetric and gynecological history (32.5%), isoserological incompatibility (25.6%), pyelonephritis during pregnancy (14.2%) and anemia of pregnant women (13.2%). It was revealed that visualization of the fetoplacental complex and measurement of peripheral resistance in the umbilical artery during the second trimester of pregnancy are not very informative. To reduce the negative impact of fetoplacental insufficiency and its timely diagnosis, it is necessary to use radiation methods for examining the motherplacentafetus system. CONCLUSIONS: For timely diagnosis of fetoplacental insufficiency and reduction of its negative impact, it is necessary to use radiation methods of studying the mother-placenta-fetus system.

Mechanism of the adverse effect of hyaluronidase used for oocyte denudation on early development of bovine embryos

Zygote ◽  
2021 ◽  
pp. 1-5
Author(s):  
Shiori Ashibe ◽  
Kanade Irisawa ◽  
Ken Yokawa ◽  
Yoshikazu Nagao
Keyword(s):  
Treatment Group ◽  
Assisted Reproductive Technologies ◽  
Cumulus Cells ◽  
Reproductive Technologies ◽  
Control Group ◽  
Free Calcium ◽  
Parthenogenetic Development ◽  
Early Embryos ◽  
Bovine Oocytes

Summary Hyaluronidase is widely used in animal and human assisted reproductive technologies (ARTs) to remove cumulus cells around oocytes. However, adverse effects of hyaluronidase treatment, such as increased rates of degeneration and parthenogenesis, have been found after treatment of human and mouse oocytes. Currently, the mechanism(s) of the detrimental effects are unclear. The present study was initiated to identify the mechanism of adverse responses to hyaluronidase treatment in bovine oocytes and early embryos. Cumulus cells were removed from cumulus–oocyte complexes (COCs) with or without hyaluronidase and the oocytes were subjected to intracytoplasmic sperm injection (ICSI) or in vitro fertilization (IVF). Significantly lower rates of blastocyst formation were obtained in the hyaluronidase treatment group after ICSI (22.4%) and IVF (21.2%) compared with the non-hyaluronidase control groups: 36.1% after ICSI and 30.4% after IVF. Next, we examined the effect of hyaluronidase on parthenogenetic development rates and on the cytoplasmic levels of free calcium ions (Ca2+), reactive oxygen species (ROS) and reduced glutathione (GSH). No differences in parthenogenesis rates were found between treated and untreated groups. Ca2+ levels in oocytes from the hyaluronidase treatment group indicated using mean fluorescence intensity were significantly higher (68.8 ± 5.3) compared with in the control group (45.0 ± 2.5). No differences were found in the levels of ROS or GSH between the treated and untreated groups. We conclude that hyaluronidase might trigger an increase in Ca2+ levels in oocytes, resulting in a decreased potential for normal embryonic development.

Features of psychoemotional condition and stress-assosiatate hormons bioproduction in pregnant women after application of assisted reproductive technologies

2018 ◽  
pp. 118-121
Author(s):  
L.M. Vygivska ◽  
◽  
I.A. Usevych ◽  
I.V. Maidannyk ◽  
V.F. Oleshko ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Emotional State ◽  
Assisted Reproductive Technologies ◽  
Past History ◽  
Reproductive Technologies ◽  
Main Group ◽  
Psychological Status ◽  
Perinatal Complications ◽  
History Of ◽  
High Level

The article represents the results of a prospective clinical and paraclinical examination of women with a history of infertility, pregnancy in which occurred as a result of the assisted reproductive technologies application. The objective: was to study the dynamics of pregnancy features of the psycho - emotional state and the concentration of stress-associated hormones in the serum of pregnant women after the application of assisted reproductive technologies in order to improve the tactics of antenatal care and prevention of obstetric and perinatal complications. Materials and methods. The main group consisted of 80 pregnant women with endocrine infertility, in which pregnancy occurred as a result of therapeutic cycles of ART, control – 50 first-pregnant women with spontaneous fertilization, taken in an arbitrary order of clinical, statistical and laboratory and instrumental studies. In pregnant women of the study groups, in order to determine the psycho emotional state in the screening mode, a clinical interview was conducted by filling out questionnaires that contained the Spilberger test questions in modification of Y.L. Hanina and «Test of relationof pregnant» by the method of I.V. Dobryakova. In the dynamics of pregnancy, the concentration of prolactin (PRL) and cortisol (K) was determined by the enzyme immunoassay on the Reader-MSR-1000 apparatus using test systems manufactured by Hema-Medicament (Russia). Results. Pregnant women with infertility in past history were characterized by a state of chronic stress. According to the results of the Spielberger test in modification Y .L. Hanina every second pregnant of main group had a high level of reactive and every fourth personal anxiety. Almost 90.0% of pregnant women after art are characterized by the presence of pathological PKGD, among which an alarming and depressive type was registered in every sixth and twelfth pregnant woman, respectively. The obtained data are confirmed by the results of the study of the level of K and PRL. For women with a history of infertility and pregnancy, which is the result of therapeutic cycles of ART, inherent in increasing concentrations of stress-associated hormones – cortisol and prolactin, which is one of the reasons for the complicated course of pregnancy and requires reasonable pathogenetic correction. Conclusion. For women who are pregnant as a result of the use of therapeutic cycles of art characterized by a high level of personal and reactive anxiety and PKGD, which confirm the presence of neuropsychiatric and afferent disorders. Increasing the concentration of stress-associated hormones is one of the causes of complicated pregnancy and requires a reasonable pathogenetic correction. Key words: pregnancy, infertility, assisted reproductive technologies, psychological status, cortisol, prolactin.

Optimization of pregnancy tactics and early preterm labor in women after assisted reproductive technologies

2018 ◽  
pp. 104-107
Author(s):  
A.S. Mandrykova ◽  
Keyword(s):  
Peripheral Blood ◽  
Premature Birth ◽  
Preterm Labor ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Perinatal Complications ◽  
Premature Rupture ◽  
Practical Medicine ◽  
Objective Reduction ◽  
Ifn Γ

The objective: reduction of the frequency of perinatal complications in women with early preterm labor after the ART, based on the improvement and implementation of the algorithm for diagnostic and therapeutic and prophylactic measures. Materials and methods.We analyzed the course of 130 single-pregnancy pregnancy women with restored fertility after the use of therapeutic assisted reproductive technologies programs that ended with early premature births. The study of the subpopulation composition of lymphocytes and the content of activation markers of peripheral blood lymphocytes was performed using the method of quadratic color laser flow cytometry and a set of monoclonal antibodies. The concentration of cytokines IFN- γ, IL-4, IL-17A, IL-17F, IL-21 and IL-22 in serum of pregnant women was determined by solid-phase immunoassay analysis. The material for studying and analyzing the morpho-functional state of the fetoplacental complex was the results of pathomorphological study of the litter in all cases of early premature birth. By our own research, we established the frequency, structure and leading causes of early premature birth after assisted reproductive technologies, optimized the tactics of conducting induced pregnancies of high obstetric risk, formulated practical recommendations for implementation in practical medicine of Ukraine. Results. For introduction into practical medicine of Ukraine with the purpose of decreasing the frequency of perinatal complications and effective provision of obstetric and gynecological care, we recommend that the following provisions be included in the clinical protocol for the management of pregnancy of high obstetric risk in women after assisted reproductive technologies: 1. To predict the risk of early premature birth in women after ancillary reproductive technologies, the diagnostic algorithm should additionally include the definition of the main indicators of the serum cytokine profile: proinflammatory serum cytokines IFN- γ, IL-2, IL-12, IL-18; anti-inflammatory regulatory cytokine IL-10; quantitative indicators of NK cells with the phenotype CD3-CD16+CD56+, CD94+ lymphocytes and peripheral blood CD71 transferrin. 2. Use of medication correction – Micronized progesterone (200 mg/day). 3. At the gestational age of 28–33 weeks, with the premature rupture of the membranes optimal and effective is the expectant management of pregnancy for 5 days with subsequent delivery of women through the natural birth canal, which makes it possible to achieve the maximum possible degree of maturity of the fetus with a minimum risk of ascending infection in newborns. Conclusions. The effectiveness of our improved algorithm is a significant reduction in women after assisted reproductive technologies, early preterm labor (2.8 times), placental dysfunction (2.3 times), premature rupture of the membranes (in 2, 1 time), fetal distress (3,6 times), abdominal degeneration (2.9 times) and implementation of intraaminal infections (2.6 times; p<0.05). The total morbidity of newborns in the early neonatal period decreased 2.4 times, and perinatal losses were absent. Key words: assisted reproductive technologies, RPP, PRPO, markers of activation of lymphocytes, cytokines.

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