The technology of intracytoplasmic sperm injection into the egg cell (ICSI) has taken the mail place among assisted reproductive technologies (ART) in the treatment of infertility. Improving the effectivenessof ART remains a complex medical problem. To a large extent, the success of ICSI depends on the quality of theoocytes, which, in its turn, depends on the number of follicles, which is determined by the ovulatory = ovarianreserve (OV) and effective preparation of patients for ART. The markers of OV are well known, and attention has been drawn to melatonin as a possible prognostic factor for the effectiveness of ART and OV in the last ten years. The indicators of melatonin content in the follicular fluid of stimulated ovaries have not been studied. At the same time, the assessment of embryological indicators of fertilization when using the medication melatonin for the preparation of patients and the effectiveness of ART programs in general can be useful for the furtherdevelopment of treatment algorithms for patients with infertility. The objective of the study. Evaluation of embryological indicators, the effectiveness of ICSI programs andthe incidence of pregnancy in women with infertility during their preparation with melatonin. Materials and methods. 67 women with various infertility factors participated in the prospective study.All patients were prepared for controlled ovarian stimulation (COS), and subsequently for follicular puncture, oocyte retrieval and fertilization by ICSI. All obtained blastocysts were cryopreserved, stored in liquid Nitrogen and thawed when embryo transfer was necessary. Embryological indicators, the number of transfers and the effectiveness of pregnancy incidence were evaluated. According to the purpose of the task, the patients were divided into two groups by the method of even-odd numbers: group 1 – 29 patients with infertility, who received the preparation "Vita-melatonin" 3 mg orally before bedtime, during one month before the follicles puncture,group 2 – 38 patients with infertility, who did not receive this medicine. Statistical processing of the obtainedresults was carried out using the licensed programs "Microsoft Excel" and "Statistica".The research design and all the methods we used in this prospective study were reviewed and approved by the bioethics commission of the higher education institution "Bukovinian State Medical University" (protocol No. 7 dated 04/21/2022). SRW "Preservation and restoration of reproductive health of women and girls with obstetric andgynecological pathology" (state registration number 0121U110020. Implementation period – 01.2021-12.2025). Results of the research. The incidence of pregnancy after thawing of blastocysts and embryo transfers ingeneral in women who received melatonin was significantly (p ˂ 0.05) higher compared to women who didnot receive melatonin, respectively, 86.2 ± 6.41% and 76.3 ± 6.95%. For all performed embryo transfers, theincidence of pregnancy was 56.8 ± 8.24% and 52.8 ± 7.62% (p > 0.05), respectively, for the first embryo transfer 58.1 ± 8 .85% and 55.3 ± 8.15% (р > 0.05), for the second - 43.5 ± 16.53% and 33.3 ± 21.14% (р > 0.05), for the third – 100.0 ± 7.00% and 80.0 ± 17.95% (р > 0.05).When assessing embryological indicators, it was found that in women who received melatonin, the number of mature oocytes was 83.4 ± 6.94%, and in women who did not receive melatonin, 81.5 ± 6.36%, but there was no significant (p > 0.05) difference. Out of mature oocytes in the process of incubation after the ICSI technology,49.5 ± 9.54% and 47.2 ± 8.72 (р > 0.05) blastocysts were formed, respectively, and from them blastocysts of class I – 48.6 ± 9 .36% and 46.4 ± 8.17% (р > 0.05), class II – 36.8 ± 8.94% and 44.4 ± 8.13% (р > 0.05), class III – 14.6 ± 6.67% and 9.3 ± 4.78% (р > 0.05).Conclusion. The use of melatonin in the preparation of women with infertility for the use of assisted reproductive technologies has shown its effectiveness in terms of pregnancy incidence.

The objective – to evaluate the results of in vitro fertilization in patients with infertilitywhen using melatonin.Material and methods. The study of 67 women with infertility was conducted on the basis of«Medical Center of Infertility Treatment» (Chernivtsi). Group A included 29 patients who tookinternally daily 1 tab. (3 mg) of the drug «Vita-melatonin» produced by Kyiv Vitamin Plant for one month before sleep two weeks before and during the controlled ovarian stimulation(COS), group B included 38 patients who did not take this drug. There were no womenamong the patients who worked night shifts. ELISA kits by IBL company (Germany) wereused to determine melatonin levels. Melatonin levels were determined in blood plasmaand follicular fluid obtained during the puncture at 9:00 am.The criteria for inclusion of patients in the study were as follows: age 22-41 years (meanage – 31.4 years), no hereditary disease or severe forms of pathozoospermia in partner,controlled ovarian stimulation (COS) using gonadotropin- releasing hormone antagonists,work with oocytes at M2 stage.The following indicators were assessed in this prospective study: the incidence ofpreembryonic development to the 4-8th cell stage, compaction and formation of blastocystsin the period from the 2nd to the 6th day of embryonic development.Statistical processing of the obtained results was performed on a personal computerusing the licensed programs «Microsoft Exelle» and «Statistica».Results. When puncturing follicles in group A, we obtained 451 oocytes during puncture,and in group B – 616. When evaluating the obtained mature oocytes, it should be notedthat we did not observe a significant difference in their quantity: 83.4 ± 6.94 % in groupA. and 81.5 ± 6.36 % in group B. From mature oocytes in the incubation process afterfertilization in group A 185 cells developed into blastocysts, which made up to 49.2± 9.54 %, and in group B – 237, which amounted to 47.2 ± 8.72 %. In the process ofblastocyst development we evaluated them by classes: class I in group A was 48.6 ±9.36 %, and in group B – 46.4 ± 8.17 %, respectively, class II – 36.8 ± 8.94 % and 44.4 ±8.13 %, class III – 14.6 ± 6.67 % and 9.3 ± 4.78 %. At first sight, it seems that in groupA there were more mature oocytes, blastocysts in general and blastocysts in class I, inclass II – less blastocysts. But, we emphasize, that a significant difference was not found.The incidence of pregnancy for all transfers in patients of group A, where women usedmelatonin in ART programs, was 56.8 ± 8.25 %, and in group B – 52.8 ± 7.62 % (p >0.05). Considering the onset of pregnancy in general, it should be noted that in group A itwas 86.2 ± 6.41 %, which was statistically different from the indicators of group B, wherethe incidence was 76.3 ± 6.95 % (p ˂ 0.001).Conclusions. The analysis of melatonin use in patients with infertility for two weeksbefore the expected menstruation and during controlled ovarian stimulation showedthat the incidence of pregnancy was generally significantly higher. Considering theembryological parameters, it should be noted that in general in this group with melatoninuse we received more mature oocytes and more blastocysts of class I, although there wasno significant difference.