Restorative reproductive medicine for infertility and recurrent miscarriage in the outpatient gynaecological practice in Ukraine

To assess the outcomes of treatment the couples with infertility or recurrent miscarriage with restorative reproductive approach and to identify predictors of success.

It was a retrospective study of 282 married couples, who were included in the program in 2 outpatient gynaecological centers in May 2010 - December 2014. The couples were observed to the end of pregnancy (or pregnancies) or withdrawal from the program. All the couples were taught to track the cycle with the Creighton Model FertilityCare System or the sympto-thermal method, and almost all received additional medical treatment. The main outcome was live birth, the secondary outcomes included conceptions, unsuccessful pregnancies, low birth weight and prematurity.

In life-table analysis, the adjusted cumulative proportion of first conceptions for those completing up to 24 months of NPT treatment was 77,7% (crude proportion 47.9%). The adjusted cumulative proportion of live births (included only women whose first pregnancy in the program was successful) was 73.6% (117 births, crude proportion 41.5%). The crude proportion of first live births (124 births, including 7 live births in women whose first pregnancy result was miscarriage) was 44%. Mean time to achieving pregnancy was 8 months (from 1 to 44 month). All the births except one were singleton. There were only 3 preterm births (gestational age less than 36 weeks) with one of them in the mentioned twin pregnancy. Only the babies of these 3 pregnancies were born with weight less than 2500 g. The favorable predictors of live birth were younger age, shorter time of trying for baby, good compliance, pregnancy in history. The unfavorable were hyperprolactinemia, uterine fibroids, endometriosis, male factor.

The outcomes of restorative reproductive treatment the couples with infertility or recurrent miscarriage in Ukraine were comparable to those in Ireland and Canada.