Danazol in the Treatment of Infertility

Danazol, an interesting pharmacologic steroid 'in search of a disease', wasfirst used by my group in the management of endometriosis because of the marked anti-endometrial effects found during clinicaltrials. The results in alleviatingdysmenorrhoea, dyspareunia. and pelvic discomfort weresurprisingly good. but more important was the 40 to 50 % pregnancy rate that occurred following discontinuation of its lise. In addition, because we suspected that women with unexplained infertility might be harbouring an occult or mtcroendometriosis, a 3 month courseof 200mg of danazol was tried in such patients, and provedeffective in overcoming infertility in roughly 40 % of patients within 6 months after discontinuation of medication. We serendipitouslyfound that somehabitualaborters carried to termafter a courseof danazol. Accordingly, a trial of JOOmg dailyfor 3 months was undertakenwith a satisfactory outcome in more instances than could be attributed to chancealone. To readily appreciate the effectiveness of this agent, one must be aware that conceptions mayfollow the useof placebos or whatever regimen is employed in about 15 to 20 % of infertile women. The unusuallygoodresults that we and other investigators in the field obtained with danazol rules out a placebo effect.