AGE AS A SOCIO-BIOLOGICAL COMPONENT OF PERINATAL RISK IN PATIENTS OF THE PREGNANCY PATHOLOGY DEPARTMENT WHO OVERCAME INFERTILITY USING ART

Abstract

In order to assess medical and social characteristics, information was copied out from registration forms N 003/у for 820 patients in the pregnancy pathology department who had overcome infertility with the help of assisted reproductive technologies (ART). It was found that among patients the proportion of women of late reproductive age was 2.1 times higher than that of early reproductive age, and the proportion of female infertility was 77.5 %. In patients of late reproductive age, not only the age at which infertility was diagnosed was significantly higher (32.50 ± 0.21 years 26.96 ± 0.20 years, respectively), but also the average time required to achieve a positive result of infertility treatment using ART (7.01 ± 0.08 years and 4.74 ± 0.07 years). Despite the fact that the majority of patients were diagnosed with female infertility in the age range of 30–34 years (37.5%), and the diagnosis of female infertility associated with male factors was made at the age of 35–39 years (32.0%), there is no statistically significant difference between the average age of diagnosis of female and male infertility (30.71±0.22 years and 30.65±0.31 years) or in the ratio of female and male infertility within each age group. In patients 35 years of age and older, there was a significantly higher proportion of women whose pregnancy occurred after the fourth or more in vitro fertilization (IVF) cycle (21.6 % versus 15.1 %), for whom it was the third or more pregnancy (32.8 % versus 22. 9 %), as well as the second or more births (29.5 % versus 9.8 %; p < 0.05). Women of late reproductive age had 1.6 times fewer medical abortions, spontaneous abortions, and negative perinatal outcomes compared to younger patients (62.2 % versus 38.0 %; p < 0.05). Among patients in the older age group, complications caused by Covid or ARVI diseases were much less common while polyhydramnios, venous complications, as well as pregnancy complications associated with disturbances in the hemostatic system and uterine fibroids were more often observed. The study showed the absence of statistically significant differences in the structure of the main diagnoses upon admission to the pregnancy pathology department depending on the age of this group of patients. Thus, despite the fact that age, as a socio-biological factor of perinatal risk, has a significant impact on certain parameters of medical, social and clinical-statistical characteristics, for patients who have overcome infertility with the help of ART, this factor is not always decisive and, above all, it is necessary to take into account the woman’s health status.