Pregnancy outcomes after controlled ovarian hyperstimulation in women with endometriosis-associated infertility: GnRH-agonist versus GnRH-antagonist

Kamila Kolańska, K Kolanska, Kolanska K, Jonathan Cohen, J Cohen, Cohen J, Bendifallah S, Sofiane Bendifallah, S Bendifallah, Lise Selleret, L Selleret, Selleret L, J.‐M. Antoine, J.-M. Antoine, Antoine JM, J-M Antoine, Chabbert-Buffet N, Nathalie Chabbert‐Buffet, N Chabbert-Buffet, Darai E, Émile Daraï, E Darai, E-M d'Argent, Emmanuelle Mathieu d’Argent, E.-M. d’Argent, d'Argent EM
Journal of gynecology obstetrics and human reproduction · 2017 · vol. 46(9) , pp. 681–686 · doi:10.1016/j.jogoh.2017.09.007 · PMID:28970135 · W2757880901
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This study compared pregnancy outcomes following controlled ovarian hyperstimulation using GnRH-agonist versus GnRH-antagonist protocols in women with endometriosis-associated infertility.

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Abstract

Background or objectiveEndometriosis is common in women referred for infertility. In vitro fertilization provides good results but the choice of the best-controlled ovarian hyperstimulation protocol remains a subject of debate. The objective of this retrospective study was to compare pregnancy outcomes in women with endometriosis-associated infertility after COH with a long agonist protocol or a six-week oral contraception-antagonist protocol.Material and methodsRetrospective analysis of a prospective database identified 284 COH cycles - 165 with GnRH-agonist protocol (GnRH-agonist group) and 119 with GnRH-antagonist protocol (GnRH-antagonist group) - in 218 women, with endometriosis from January 2013 to October 2015.ResultsNo difference in the epidemiological characteristics was found between the groups. Per started cycle, pregnancy and live-birth rates after fresh embryo transfer were higher with the GnRH-agonist protocol (25% vs. 13%, P=0.02 and 18% vs. 8%, P=0.04, respectively). Considering analysis per cycle with embryo transfer, the pregnancy rate was similar in both groups while the live-birth rate was higher in the GnRH-agonist group (29% vs. 17%, P=0.053 and 22% vs. 10%, P=0.02, respectively). No difference was observed between the groups with freeze-thaw embryo transfer. Subgroup analysis (endometrioma alone, deep infiltrating endometriosis with and without endometrioma, endometriosis with and without adenomyosis) revealed no difference between the groups for either pregnancy or live-birth rates.ConclusionA GnRH-agonist protocol appears to result in higher pregnancy and live-birth rates after fresh embryo transfer in women with endometriosis-associated infertility, suggesting that a GnRH-antagonist protocol might negatively impact endometrial receptivity.

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Condition tags

endometriosisinfertility

MeSH descriptors

Endometriosis Fertility Agents, Female Infertility Ovulation Induction Pregnancy Outcome Uterine Diseases Adult Endometriosis Endometriosis Endometriosis Female Fertility Agents, Female Fertilization in Vitro Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone Hormone Antagonists Hormone Antagonists Humans Infertility

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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