Results of in Vitro Fertilization in Sterility Patients Using Melatonin

Abstract

The objective – to evaluate the results of in vitro fertilization in patients with infertilitywhen using melatonin.Material and methods. The study of 67 women with infertility was conducted on the basis of«Medical Center of Infertility Treatment» (Chernivtsi). Group A included 29 patients who tookinternally daily 1 tab. (3 mg) of the drug «Vita-melatonin» produced by Kyiv Vitamin Plant for one month before sleep two weeks before and during the controlled ovarian stimulation(COS), group B included 38 patients who did not take this drug. There were no womenamong the patients who worked night shifts. ELISA kits by IBL company (Germany) wereused to determine melatonin levels. Melatonin levels were determined in blood plasmaand follicular fluid obtained during the puncture at 9:00 am.The criteria for inclusion of patients in the study were as follows: age 22-41 years (meanage – 31.4 years), no hereditary disease or severe forms of pathozoospermia in partner,controlled ovarian stimulation (COS) using gonadotropin- releasing hormone antagonists,work with oocytes at M2 stage.The following indicators were assessed in this prospective study: the incidence ofpreembryonic development to the 4-8th cell stage, compaction and formation of blastocystsin the period from the 2nd to the 6th day of embryonic development.Statistical processing of the obtained results was performed on a personal computerusing the licensed programs «Microsoft Exelle» and «Statistica».Results. When puncturing follicles in group A, we obtained 451 oocytes during puncture,and in group B – 616. When evaluating the obtained mature oocytes, it should be notedthat we did not observe a significant difference in their quantity: 83.4 ± 6.94 % in groupA. and 81.5 ± 6.36 % in group B. From mature oocytes in the incubation process afterfertilization in group A 185 cells developed into blastocysts, which made up to 49.2± 9.54 %, and in group B – 237, which amounted to 47.2 ± 8.72 %. In the process ofblastocyst development we evaluated them by classes: class I in group A was 48.6 ±9.36 %, and in group B – 46.4 ± 8.17 %, respectively, class II – 36.8 ± 8.94 % and 44.4 ±8.13 %, class III – 14.6 ± 6.67 % and 9.3 ± 4.78 %. At first sight, it seems that in groupA there were more mature oocytes, blastocysts in general and blastocysts in class I, inclass II – less blastocysts. But, we emphasize, that a significant difference was not found.The incidence of pregnancy for all transfers in patients of group A, where women usedmelatonin in ART programs, was 56.8 ± 8.25 %, and in group B – 52.8 ± 7.62 % (p >0.05). Considering the onset of pregnancy in general, it should be noted that in group A itwas 86.2 ± 6.41 %, which was statistically different from the indicators of group B, wherethe incidence was 76.3 ± 6.95 % (p ˂ 0.001).Conclusions. The analysis of melatonin use in patients with infertility for two weeksbefore the expected menstruation and during controlled ovarian stimulation showedthat the incidence of pregnancy was generally significantly higher. Considering theembryological parameters, it should be noted that in general in this group with melatoninuse we received more mature oocytes and more blastocysts of class I, although there wasno significant difference.