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

Kamila Kolańska, K Kolanska, Kolanska K, Cohen J, J. Cohen, Jonathan Cohen, Bendifallah S, Sofiane Bendifallah, S. Bendifallah, Lise Selleret, L. Selleret, Selleret L, 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 OBJECTIVE: Endometriosis 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 METHODS: Retrospective 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. RESULTS: No 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. CONCLUSION: A 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 Adult Endometriosis Endometriosis Endometriosis Endometriosis Female Female Fertility Agents, Female Fertility Agents, Female Fertilization in Vitro Fertilization in Vitro Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone

Citation neighborhood (2-hop)

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. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

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