Role of adjuvant hormonal therapy in treatment of endometriosis-assosiated infertility

Cover Page


Cite item

Full Text

Abstract

Background. In vitro fertilization (IVF) represents the most efficient means of overcoming endometriosis-related infertility. Objective. To investigate the outcomes of in vitro fertilization cycles after controlled ovarian hyperstimulation in patience operated for endometrioma after different adjuvant hormonal therapy. Material and methods. 144 patients with endometriosis-associated infertility undergoing IVF were divided into three groups: GnRH agonist administration; dienogest 2 mg daily administration; women without adjuvant therapy. Results. Сlinical pregnancy rates were 2,5 times higher (44,7 and 16,7 % respectively; p = 0,01) and live birth rate was 3 times higher (36,8 и 11,1 % respectively; p = 0,01) in dienogest administration group before IVF/ICSI cycle in comparison with no adjuvant therapy groups, respectively. Conclusion. Considering the clinical pregnancy and live birth rate rates dienogest administration may be effective in patients with mild-to-moderate endometriosis prior to IVF/ICSI cycle.

About the authors

Dmitriy Alexandrovich Gerkulov

I.P. Pavlov First State Medical University of St. Petersburg

Email: gerkulov@gmail.com
post-graduate student, Department of obstetrics, gynecology and reproductology

References

  1. Benagiano G., Brosens I., Habiba M. Structural and molecular features of the endomyometrium in endometriosis and adenomyosis. Hum. Reprod. Update. 2014; 20: 386-402.
  2. Brosens I. A., de Sutter P., Hamerlynck T., Imeraj L., Yao Z., Cloke B. et al. Endometriosis is associated with a decreased risk of pre-eclampsia. Hum. Reprod. 2007; 22: 1725-9.
  3. Conti N., Cevenini G., Vannuccini S., Orlandini C., Valensise H., Gervasi M. T. et al. Women with endometriosis at first pregnancy have an increased risk of adverse obstetric outcome. J. Matern. Fetal Neonatal. Med. 2015; 28:1795-8.
  4. Foster R. H., Wilde M. I. Dienogest. Drugs. 1998; 56 (5): 825-33.
  5. Giudice L. C., Kao L. C. Endometriosis. Lancet. 2004; 364: 1789-99.
  6. Gupta S., Agarwal A., Agarwal R., Loret de Mola J. R. Impact of ovarian endometrioma on assisted reproduction outcomes. Reprod. Biomed. Online. 2006; 13: 349-60.
  7. Hayashi A., Tanabe A., Kawabe S., Hayashi M., Yuguchi H., Yamashita Y. et al. Dienogest increases the progesterone receptor isoform B/A ratio in patients with ovarian endometriosis. J. Ovarian. Res. 2012; 5: 31.
  8. Kao L. C., Germeyer A., Tulac S., Lobo S., Yang J. P., Taylor R. N. et al. Expression profiling of endometrium from women with endometriosis reveals candidate genes for disease-based implantation failure and infertility. Endocrinology. 2003; 144: 2870-81.
  9. Katsuki Y., Takano Y., Futamura Y. et al. Effects of dienogest, a synthetic steroid, on experimental endometriosis in rats. Eur. J. Endocrinol. 1998; 138: 216-6.
  10. Kitajima M., Dolmans M. M., Donnez O. et al. Enhanced follicular recruitment and atresia in cortex derived from ovaries with endometriomas. Fertil. Steril. 2014; 101 (4): 1031-7.
  11. Lin H., Leng J. H., Liu J. T., Lang J. H. Obstetric outcomes in Chinese women with endometriosis: a retrospective cohort study. Chin. Med. J. 2015; 128: 455-8.
  12. Petraglia F., Arcuri F., de Ziegler D., Chapron C. Inflammation: a link between endometriosis and preterm birth. Fertil. Steril. 2012; 98: 36-40.
  13. Sallam H. N., Garcia-Velasco J. A., Dias S., Arici A. Long-term pituitary down-regulation before in vitro fertilization (IVF) for women with endometriosis. Cochrane Database Syst. Rev. 2006; 1: CD004635.

Copyright (c) 2015 Gerkulov D.A.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies