Endometriosis management prior to IVF

E. V. Vartanyan, К. А. Цатурова, Natalia Petukhova, Alexander Markin, Maria Uskova, E. A. Devyatova
In: Gynecological Endocrinology · 2015 · vol. 31(sup1) , pp. 42–45 · doi:10.3109/09513590.2015.1086506 · W1904466130
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Dienogest administration prior to IVF in infertile patients with adenomyosis and prior IVF failures improved IVF effectiveness, normalized menstruation, and decreased pelvic pain in a prospective cohort study.

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Abstract

Endometriosis affects up to 10% of reproductive-aged women; with higher prevalence among patients suffering from dysmenorrhea, infertility and chronic pelvic pain (CPP). Early detection is the basis of targeting at time therapy. Administration of GnRH-agonists (GnRHa) is limited with its safety and portability. Dienogest administration as the stage of preparation to in vitro fertilization (IVF) may provide the preparative pre-gravid reserve. Fifty-six infertile patients with adenomyosis and previous IVF failures were recruited for prospective cohort study. The treatment followed the unique algorithm created using clinical experience. Post-transfer support was also considered. The aims included evaluation of dienogest effectiveness for different stages of adenomyosis; working out the schemes of dienogest therapy prior to IVF; evaluation of IVF effectiveness after dienogest administration. Patients with adenomyosis grade I–II demonstrated encouraging results: normalisation of menstrual function in 68.6% cases; decreasing of CPP in 74.3% of patients; better uterine vascularisation in 48.6% cases; IVF effectiveness increased up to 48.6%. Thus, in cases of adenomyosis and previous IVF failures dienogest should be administrated prior to IVF, which results in higher IVF effectiveness.

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Condition tags

endometriosisadenomyosischronic_pelvic_paindysmenorrheainfertility

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