The role of ovarian biopsy in assessing the state of ovarian reserve before assisted reproductive technologies

Abstract

DOI: 10.52705/2788-6190-2026-02-12
УДК 618.177-089.888.11-02:618.11-076:612.621.9

The objective: to assess the state of ovarian reserve before assisted reproductive technologies.
Materials and methods. This retrospective study included 45 women who sought assisted reproductive technologies. The main group (1C) included 15 women who had a history of ovarian tissue biopsy to determine their follicular reserve. All patients underwent ovarian biopsy during diagnostic laparoscopy. All patients in the main group presented to the department of assisted reproductive technologies after surgical intervention. The interval between ovarian biopsy and ovarian stimulation varied from 6 months to 3 years. The control group (2C) consisted of 30 women who sought assisted reproductive technologies during the same time period and had no history of surgical interventions on the reproductive system organs. The complex of conducted studies included clinical, laboratory, instrumental, and statistical methods.
Results. Significantly higher total reproductive losses were observed in the main group – 67 %, while in the control group this indicator was 30 %. In patients of group 1C (with a history of biopsy), the frequency of non-developing pregnancies and spontaneous miscarriages was 67 %. In the control group: 1 patient was diagnosed with an ectopic pregnancy (4 %), 3 with non-developing pregnancies (13 %), and the remaining 13 % were spontaneous miscarriages. Thus, it can be assumed that ovarian tissue biopsy cannot be considered a reliable functional test for determining ovarian reserve or recommended as a stage of infertility diagnosis for predicting in vitro fertilization efficiency in patients with infertility.
Conclusions. Ovarian biopsy performed on women suffering from infertility creates a group of patients with a «poor response» of ovaries to ovarian stimulation during in vitro fertilization. A «poor response» of ovaries to stimulation during in vitro fertilization is indicative in itself. At the current stage of development of assisted reproductive technologies, infertility treatment should begin with ovulation induction during in vitro fertilization. And only when evaluating the ovarian response to stimulation with exogenous gonadotropins and its ineffectiveness should the question of applying biopsy in such patients be raised.