Menotropin stimulation after prolonged gonadotropin releasing hormone agonist pretreatment for in vitro fertilization in patients with endometriosis

Kiyoshi Nakamura, K. Nakamura, Nakamura K, M. Oosawa, Oosawa M, Kondou I, Ikuyo Kondou, I Kondou, Shirou Inagaki, S Inagaki, Inagaki S, Hitoshi Shibata, H Shibata, Shibata H, O Narita, Narita O, Nobuhiko Suganuma, N Suganuma, Suganuma N, Tomoda Y, Y Tomoda, Yutaka Tomoda
Journal of assisted reproduction and genetics · 1992 · vol. 9(2) , pp. 113–117 · doi:10.1007/bf01203749 · PMID:1627925 · W1975195041
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Prolonged Gn-RHa suppression before menotropin stimulation improved IVF clinical pregnancy rates in endometriosis patients compared to a standard long protocol.

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This study compared two IVF-ET ovarian stimulation protocols in patients with various stages of endometriosis who were resistant to conventional therapies: an ultralong protocol using at least 60 days of gonadotropin-releasing hormone agonist (Gn-RHa) pretreatment before menotropin stimulation, versus a long protocol with Gn-RHa started at midluteal phase followed by exogenous gonadotropins after pituitary suppression. Estradiol response and numbers of retrieved oocytes, fertilized oocytes, cleaved oocytes, and transferred embryos were similar between groups, but the clinical pregnancy rate per transfer was higher with the ultralong protocol (67% vs 27%). The miscarriage rate reported was 14% (2/14) in the ultralong group. This paper is centrally about endometriosis — it evaluates IVF stimulation outcomes after prolonged Gn-RHa pretreatment in endometriosis patients.

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Abstract

Two protocols were scheduled for in vitro fertilization and embryo transfer (IVF-ET) in patients with various stages of endometriosis who were resistant to conventional therapies. In the ultralong protocol (21 patients), gonadotropin releasing hormone agonist (Gn-RHa) was administered for at least 60 days prior to ovarian stimulation along with menotropin until human chorionic gonadotropin was injected. In the long protocol (11 patients), Gn-RHa was started at the midluteal phase and exogenous gonadotropin was commenced between the third and the seventh day of the menstrual cycle after pituitary suppression. The estradiol response and the number of retrieved oocytes, fertilized oocytes, cleaved oocytes, and transferred embryos were similar in both groups but the clinical pregnancy rate per transfer was superior in the ultralong protocol (67 vs 27%). The miscarriage rate was 14% (2/14) in the ultralong protocol. Prolonged Gn-RHa suppression of ovarian function before superovulation may overcome some causes of infertility in patients with endometriosis.
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Abstract

Two protocols were scheduled for in vitro fertilization and embryo transfer (IVF-ET) in patients with various stages of endometriosis who were resistant to conventional therapies. In the ultralong protocol (21 patients), gonadotropin releasing hormone agonist (Gn-RHa) was administered for at least 60 days prior to ovarian stimulation along with menotropin until human chorionic gonadotropin was injected. In the long protocol (11 patients), Gn-RHa was started at the midluteal phase and exogenous gonadotropin was commenced between the third and the seventh day of the menstrual cycle after pituitary suppression. The estradiol response and the number of retrieved oocytes, fertilized oocytes, cleaved oocytes, and transferred embryos were similar in both groups but the clinical pregnancy rate per transfer was superior in the ultralong protocol (67 vs 27%). The miscarriage rate was 14% (2/14) in the ultralong protocol. Prolonged Gn-RHa suppression of ovarian function before superovulation may overcome some causes of infertility in patients with endometriosis. Similar content being viewed by others

References

Mahadevan MM, Trounson AO, Leeton JF: The relationship of tubal blockage, infertility of unknown cause, suspected male infertility, and endometriosis to success of in vitro fertilization and embryo transfer. Fertil Steril 1983;40:755 Chillik CF, Acosta AA, Garcia JE, Perera S, Uem JFHM, Rosenwaks Z, Jones HW: The role of in vitro fertilization in infertile patients with endometriosis. Fertil Steril 1985;44:56 Matson PL, Yovich JL: The treatment of infertility associated with endometriosis by in vitro fertilization. Fertil Steril 1986;46:432 Damewood MD, Rock JR: Treatment independent pregnancy with operative laparoscopy for endometriosis in an in vitro fertilization program. Fertil Steril 1988;50:463 Oehninger S, Acosta AA, Kreiner D, Muasher SJ, Jones HW, Rosenwaks Z: in vitro fertilization and embryo transfer; an established and successful therapy for endometriosis. J Vitro Fert Embryo Transfer 1988;5:249 Oehninger S, Bryski RG, Muasher SJ, Acosta AA, Jones GS: In vitro fertilization and embryo transfer in patients with endometriosis; Impact of a gonadotropin releasing hormone agonist. Hum Reprod 1989;4:541 Dicker D, Goldman GA, Ashkenazi J, Feldberg D, Voliovitz I, Goldman JA: The value of pre-treatment with gonadotropin releasing hormone (Gn-RH) analogue in IVF-ET therapy of severe endometriosis. Hum Reprod 1990;5:418 Dale PO, Tanbo T, Abyholm T: Endometriosis associated infertility treated by long-term gonadotropin releasing hormone agonist administration and assisted fertilization. J Vitro Fert Embryo Transfer 1990;7:181 Remorgida V, Costa M, Anserini P, Ferraiolo A, Croce S, Capitanio GL: Comparison of different ovarian stimulation protocols for gamete intrafallopian transfer in patients with minimal and mild endometriosis. Fertil Steril 1990;6:53 Weed JC, Arquemboug PC: Endometriosis: Can it produce an autoimmune response resulting in infertility? Clin Obstet Gynecol 1980;23:885 Author information Authors and Affiliations Rights and permissions About this article Cite this article Nakamura, K., Oosawa, M., Kondou, I. et al. Menotropin stimulation after prolonged gonadotropin releasing hormone agonist pretreatment for in vitro fertilization in patients with endometriosis. J Assist Reprod Genet 9, 113–117 (1992). https://doi.org/10.1007/BF01203749 Received: Accepted: Issue date: DOI: https://doi.org/10.1007/BF01203749

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Condition tags

endometriosis

MeSH descriptors

Buserelin Endometriosis Fertilization in Vitro Infertility, Female Menotropins Ovulation Induction Adult Antigens, Tumor-Associated, Carbohydrate Antigens, Tumor-Associated, Carbohydrate Buserelin Buserelin Endometriosis Female Fertilization in Vitro Humans Infertility, Female Menotropins Menotropins Pregnancy Treatment Outcome

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