The sample of 93 patients with an average age of 46.64 years has completed two-year monitoring, showing that SEGOVA has a favorable effect on the endocrine status and on the reproductive outcome of patients.
All patients had sonographic follow-ups for a period of two years from the procedure. The same group of 93 patients also monitored hormone levels of FSH, LH for a period of two years, while follow-up for E2 lasted 18 months and for PG and AMH 6 months, due to the limited number of participants who completed the aforementioned analyzes. The study was conducted at the Special Gynecology Clinic – Jevremova Belgrade, Saint James Malta Hospital, Remedica Skopje Clinic, 2015-2019.
Preliminary laboratory analyses were performed in all patients and questionnaires were given about menstruation, parity, the presence of a POF diagnosis in family medical history, educational level, and possible sources of stress prior to amenorrhea. They were also given the quality of life questionnaires.
- Primary sterility was diagnosed in 61 patients, while secondary sterility was reported in 30 patients.
- 18 patients were diagnosed with POF. Endocrine disorders were reported in 22 patients, while 10 patients had a diagnosis of endometrial disease.
Our results show that the effects of the intervention on FSH levels could be seen already after 3 months when FSH starts declining, while the most pronounced reduction was achieved after 24 months (39%). (Table 1) The effects of the intervention on LH could be seen already after 3 months, when its concentration starts declining, while a decrease is the most pronounced at 24 months post-intervention (44%).
|Patients No.||Follicles No.||Egg Cells No.||Embryos No.||Embryo transfer No.||Vitrified Embryos No.||Pregnancies No.||Live births No.|
|The number of patients with a positive result:||57 follicle positive women||23 egg positive women||19 embryo positive women||12 women with ET||9 women with vitrified embryos||9 pregnant women||3 women with live birth|
|The percentage of patients with a positive result:||61.29%||24.73%||20.43%||12.90%||9.67%||9.67%||5.37%|
|Successful rates:||40.35% out of women who had follicles||82.60% out of women who had eggs||63.15% out of women who had embryos||47.36% out of women who had embryos|
The rise in estradiol (E2) levels was recorded at 3 months post-intervention, while an increase is the most pronounced at 18 months (68%). The increase in progesterone levels was recorded at 6 months post-intervention (8%). After 3 and 6 months, there was an increase in the level of AMH hormone (26%, 22.4%, respectively).
The total results of ultrasonography for 93 patients that completed the two-year follow-up show during 24 months period after the re-transplantation 61% of patients had the presence of a follicle. Attempts to perform oocyte retrieval resulted in aspirated oocytes in 40.4% follicle positive women (24.7% out of the total number of patients). The fertilization rate of the aspirated oocytes was 78%, resulting in embryos in 20.4% of women out of the total number of patients. Embryo transfers were performed in 63% embryo positive women (12,9% out of the total number of patients), while 47% embryo positive women had vitrified embryos (9.7% out of the total number of patients had embryos vitrified). Three patients spontaneously conceived after transplantation, while four pregnancies were conceived with IVF. Two additional pregnancies were achieved with additional reproductive techniques. 9.67% of the total number of patients were pregnant. So far, out of total 9 pregnancies, 3 pregnancies ended with a missed miscarriage and one pregnancy was lost due to abnormal karyotype, while 3 pregnancies resulted in the successful birth of 4 newborns (one of them Gemelli pregnancy).