Current view оn protocols of controlled ovarian hyperstimulation in women of reproductive age with different ovarian reserve

Reproductology is one of the most dynamically developing branches of modern medical science. It becomes especially important in the context of changes of recent years in society, the main of which is the postponement of childbirth compared to previous generations. In addition, such an important and multifactorial problem as infertility encourages scientists to find different ways to overcome it, taking into account the number of etiological factors and different initial reproductive potential of each member of the couple. In vitro fertilization (IVF) can comprehensively solve the problem, as the procedure involves the reconstruction of the process of fertilization under the supervision of the specialist, «bypassing» the critical points that are often affected by pathological processes in male or female organism. One of the main parameters that determines the prospects of using of these assisted reproductive technologies and, in fact, the strategy of IVF cycles, is ovarian reserve, which characterizes the functional ability of the ovary to generate a follicle independently / in response to exogenous influences. In recent decades, many methods have been proposed to assess it and to predict the so-called poor, «bad» ovarian response to stimulation. It goes in accordance with the fact that for patients with reduced ovarian reserve, it is advisable to use adapted schemes of controlled ovarian hyperstimulation (COH), which takes into account the main pathophysiological properties of folliculogenesis in this category of women. Numerous studies show different data on the effectiveness of gonadotropic hormones (gonadotropins, HT) of different origin in women with different ovarian reserve. This article highlights modern ideas about controlled ovarian hyperstimulation using gonadotropic hormones of various origins, demonstrates the main clinical aspects of implementation of available markers of reduced ovarian reserve, analyzes data on the effectiveness of administration of gonadotropin of different origin in patients with different ovarian reserve and possible measures to increase the efficiency of IVF cycles in patients with reduced ovarian reserve. Keywords: in vitro fertilization, controlled ovarian hyperstimulation, ovarian reserve, gonadotropins.