Здравствуйте! 2-ая попытка ЭКО, мне 30 лет, мужу 32. Перенесли 2 эмбриона на 3-ий день (4-ёх и 6-ти клеточных), после подсадки явка к врачу только на 14-ый для сдачи ХГЧ, хочу сама проконтролировать, достаточная ли у меня поддержка, получается, что назначили её мне методом тыка! Сдала анализы на 5-ый день после подсадки эмбрионов, эстадиол -1234, прогестерон - 167,5, скажите маловато это или как, ещё планирую сдать на 8-ой день, может ещё какие-то анализы сдать??? На 5-ый и 6-ой день после подсадки была высокая температура до 38,5, грешу на горло, немного болело, всё резко прошло и температура тоже опустилась до 37. Что это? Не знаю!!! Очень волнуюсь, жду Вашего ответа!
Это скорее устоявшиеся стереотипы, которые не имеют ничего общего с данными доказательной медицины.
По мониторингу цикла эко доказано, что достаточно только уз-мониторинга.
Cochrane Database Syst Rev. 2008 Apr 16;(2):CD005289.
Monitoring of stimulated cycles in assisted reproduction (IVF and ICSI).
Kwan I, Bhattacharya S, McNeil A, van Rumste MM.
National Collaborating Centre For Women's and Children's Health, King's Court, 4th floor, 2-16 Goodge Street, London, UK, W1T 2QA. ikwan@ncc-wch.org.uk.
Abstract
BACKGROUND: Traditional monitoring of ovarian hyperstimulation during in vitro fertilisation (IVF) treatment has included ultrasonography plus serum estradiol concentration to ensure safe practice by reducing the incidence and severity of ovarian hyperstimulation syndrome (OHSS). The need for intensive monitoring during ovarian stimulation in IVF is controversial. It has been suggested that close monitoring is time consuming, expensive and inconvenient for the woman and simplification of IVF therapy by using ultrasound only should be considered. This systematic review assessed the effects of ovarian monitoring by ultrasound only versus ultrasound plus serum estradiol measurement on IVF outcomes and the occurrence of OHSS in women undergoing stimulated cycles in IVF and intra-cytoplasmic sperm injection (ICSI) treatment.
OBJECTIVES: To quantify the effect of monitoring controlled ovarian stimulation in IVF and ICSI cycles with ultrasound plus serum estradiol concentration versus ultrasound only in terms of live birth rates, pregnancy rates and the incidence of OHSS.
SEARCH STRATEGY: We searched the Menstrual Disorders and Subfertility Group Specialised Register of controlled trials, Cochrane Central Register of Controlled Trials (CENTRAL) on the latest issue of The Cochrane Library, MEDLINE (1966 to May 2007), EMBASE (1980 to May 2007), CINAHL (1982 to May 2007), the National Research Register, and web-based trial databases such as Current Controlled Trials. There was no language restriction. Additionally all references in the identified trials and background papers were checked and authors were contacted to identify relevant published and unpublished data.
AUTHORS' CONCLUSIONS: There is no evidence from randomised trials to support cycle monitoring by ultrasound plus serum estradiol as more efficacious than cycle monitoring by ultrasound only on outcomes of live birth and pregnancy rates. A large well-designed randomised controlled trial is needed that reports on live birth rates and pregnancy, with economic evaluation of the costs involved and the views of the women undergoing cycle monitoring. A randomised trial with sufficiently large sample size to test the effects of different monitoring protocols on OHSS, a rare outcome, will pose a great challenge. Until such a trial is considered feasible, cycle monitoring by transvaginal ultrasound plus serum estradiol may need to be retained as a precautionary good practice point.
По пддержке лютеиновой фазы. Не весь прогестерон (особенно вагинальные формы) определяется в крови как прогестерон. Назначение препаратов ХГЧ не дает никаких приемыществ.
Cochrane Database Syst Rev. 2008 Jul 16;(3):CD004830.
WITHDRAWN: Luteal phase support in assisted reproduction cycles.
Daya S, Gunby JL.
Department of Obstetrics & Gynecology, Clinical Epidemiology & Biostatistics, 2407 Carrington Place, Oakville, Ontario, Canada, L6J 7R6.
Update of:
Cochrane Database Syst Rev. 2004;(3):CD004830.
AUTHORS' CONCLUSIONS: Luteal phase support with hCG or progesterone after assisted reproduction results in an increased pregnancy rate. hCG does not provide better results than progesterone, and is associated with a greater risk of OHSS when used with GnRHa. The optimal route of progesterone administration has not yet been established.