RCT to evaluate the influence of adjuvant medical treatment of peritoneal endometriosis on the outcome of IVF

Decleer, W; Osmanagaoglu, Kaan; Verschueren, Katrien; Comhaire, Frank; Devroey, Paul

doi:10.1093/humrep/dew148

Cited by 40 publications

(49 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our study showed no clear negative effect of the lower LH level in the control group. However, ultralong pituitary downregulation may suppress the ovarian response to Gn [26], and our results are consistent with this finding. The control group required a higher Gn dose and longer time for stimulation.…”

Section: Discussionsupporting

confidence: 91%

“…Conflicting results have been reported regarding oocyte quality between patients with EMs and controls [25]. A randomized controlled trial showed that 3-month GnRH agonist treatment for peritoneal EMs prior to IVF did not produce a better outcome, such as a greater number of MII oocytes, compared with a longer protocol [26]. Van der Houwen found that ultralong pituitary downregulation can achieve a limited favorable effect in ongoing pregnancy in women who had experienced severe EMs during fresh cycles [27].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy and Safety of In Vitro Fertilization (IVF)/Intracytoplasmic Sperm Injection (ICSI) Among Patients with Endometriosis After a Shortened Protocol of Long-Term Pituitary Downregulation

Kong

Guo

et al. 2019

Med Sci Monit

View full text Add to dashboard Cite

Background Patients with endometriosis (EMs) are routinely advised to take GnRH-a for 3–6 months to improve the internal reproductive environment, but this may not be necessary. Material/Methods This retrospective study examined the effects of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) with shortened (n=311) or conventional (n=213) long-term pituitary downregulation in EMs patients between January 2013 and July 2017. Results The 2 groups showed no significant differences in gonadotropin (Gn) dose, number of oocytes retrieved, or miscarriage rate. Follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) levels on the initiation day and the LH level on human chorionic gonadotropin (hCG) day (1.22±1.39 vs. 0.74±0.55 P=0.0026) were higher in the study group than in the control group. The cumulative live birth rates in the second cycle were 69.13% in the study group (95% confidence interval (CI), 64–74.27%) vs. 68.54% in the control group (95% CI, 62.31–74.78%, P=0.88, respectively). Conclusions This study showed that the shortened regimen and the ultralong regimen did not produce different pregnancy outcomes after ART, and the single-application, long-term GnRH-a protocol may serve as a cost-effective and safe treatment protocol for EMs patients.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of In Vitro Fertilization (IVF)/Intracytoplasmic Sperm Injection (ICSI) Among Patients with Endometriosis After a Shortened Protocol of Long-Term Pituitary Downregulation

Kong

Guo

et al. 2019

Med Sci Monit

View full text Add to dashboard Cite

show abstract

“…Predictably, higher doses of FSH and a longer stimulation were also required for ovarian stimulation in the group receiving GnRH agonist pre-treatment. However, patients included were women not affected by ovarian endometriosis and surgically treated for peritoneal endometriosis, who were either assigned to immediate IVF after surgery or to post-surgical 3-month GnRH agonist treatment and subsequent IVF [84]. Hence, no information can be obtained about the benefits of GnRH agonist in the presence of ovarian endometriomas or in patients who have not undergone surgical treatment for endometriosis.…”

Section: Potential Impact On Clinical Practicementioning

confidence: 99%

Is the oocyte quality affected by endometriosis? A review of the literature

et al. 2017

View full text Add to dashboard Cite

Endometriosis is an estrogen-dependent chronic inflammatory condition that affects women in their reproductive period causing infertility and pelvic pain. The disease, especially at the ovarian site has been shown to have a detrimental impact on ovarian physiology. Indeed, sonographic and histologic data tend to support the idea that ovarian follicles of endometriosis patients are decreased in number and more atretic. Moreover, the local intrafollicular environment of patients affected is characterized by alterations of the granulosa cell compartment including reduced P450 aromatase expression and increased intracellular reactive oxygen species generation. However, no comprehensive evaluation of the literature addressing the effect of endometriosis on oocyte quality from both a clinical and a biological perspective has so far been conducted. Based on this systematic review of the literature, oocytes retrieved from women affected by endometriosis are more likely to fail in vitro maturation and to show altered morphology and lower cytoplasmic mitochondrial content compared to women with other causes of infertility. Results from meta-analyses addressing IVF outcomes in women affected would indicate that a reduction in the number of mature oocytes retrieved is associated with endometriosis while a reduction in fertilization rates is more likely to be associated with minimal/mild rather than with moderate/severe disease. However, evidence in this field is still far to be conclusive, especially with regards to the effects of different stages of the disease and to the impact of patients’ previous medical/surgical treatment(s).

show abstract

“…PR are also enhanced if GnRH agonists are administered prior to IVF. Postoperative medical treatment does not seem to incite a rise in PR, in women aiming at spontaneous conception, while they also add an unwanted time delay ( 30 , 81 ). Opøien et al ( 82 ), have underlined the important role of surgery in eradicating macroscopic lesions.…”

Section: Endometriosis-associated Infertilitymentioning

confidence: 99%

Endometriosis and in vitro fertilisation (Review)

et al. 2018

View full text Add to dashboard Cite

The aim of the present review was to discuss a matter of concern in the clinical field of obstetrics/gynecology, namely the potency of in vitro fertilization (IVF) in the management of endometriosis-associated infertility. Endometriosis is a medical condition affecting one tenth of women in their fertile years, and accounts for up to 50% of infertile women. Thus, such high prevalence has established the necessity for investigating the effectiveness of available techniques in eradicating the disease and constraining infertility as well as the accompanying pain symptoms of endometriosis. The underlying mechanisms connecting endometriosis with low fecundity have been extensively studied, both in terms of genetic alterations and epigenetic events that contribute to the manifestation of an infertility phenotype in women with the disease. Several studies have dealt with the impact of IVF in pregnancy rates (PRs) on patients with endometriosis, particularly regarding women who wish to conceive. Results retrieved from studies and meta-analyses depict a diverse pattern of IVF success, underlining the involvement of individual parameters in the configuration of the final outcome. The ultimate decision on undergoing IVF treatment should be based on objective criteria and clinicians' experience, customized according to patients' individual needs.

show abstract

RCT to evaluate the influence of adjuvant medical treatment of peritoneal endometriosis on the outcome of IVF

Abstract: 8 March 2012.

Cited by 40 publications

References 15 publications

Efficacy and Safety of In Vitro Fertilization (IVF)/Intracytoplasmic Sperm Injection (ICSI) Among Patients with Endometriosis After a Shortened Protocol of Long-Term Pituitary Downregulation

Efficacy and Safety of In Vitro Fertilization (IVF)/Intracytoplasmic Sperm Injection (ICSI) Among Patients with Endometriosis After a Shortened Protocol of Long-Term Pituitary Downregulation

Is the oocyte quality affected by endometriosis? A review of the literature

Endometriosis and in vitro fertilisation (Review)

Contact Info

Product

Resources

About