Effect of Prolonged GnRH Agonist Downregulation on ICSI Outcome in Patients With Endometriomas of Less Than 5 cm: A Randomized Controlled Trial

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Prolonged GnRH agonist downregulation significantly improved chemical, clinical, and ongoing pregnancy rates in patients with small endometriomas undergoing ICSI.

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This randomized controlled trial evaluated whether prolonged GnRH agonist downregulation improves ICSI outcomes in women with a unilateral single endometrioma smaller than 5 cm, comparing standard long GnRH agonist protocol versus three 3.75 mg IM triptorelin injections 28 days apart followed by the standard long protocol. Ninety participants indicated for ICSI were randomized to 45 per group, and the groups were similar in clinical and hormonal characteristics; cycle metrics such as retrieved oocytes, fertilized oocytes, and transferred embryos were also not significantly different. Despite this, the prolonged GnRH agonist group had significantly higher chemical, clinical, and ongoing pregnancy rates. The paper’s conclusion is based on pregnancy outcomes rather than reporting any explicit limitation in the provided text, and it focuses specifically on small endometriomas under 5 cm. This paper is centrally about endometriosis — it tests prolonged GnRH agonist downregulation to improve ICSI pregnancy outcomes in patients with small endometriomas.

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Abstract

ObjectiveTo evaluate the effect of prolonged Gonadotropin releasing hormone (GnRH) agonist downregulation in patients with endometriomas of less than 5 cm on the outcome of the proceeding Intracytoplasmic sperm injection (ICSI) trial.MethodsIn a randomized controlled trial at a university teaching hospital, 90 patients indicated for ICSI and having unilateral single endometrioma of less than 5 cm in diameter were randomized into 2 groups. Group A (45 patients) received the standard long protocol; whereas group B (45 patients) received 3 consecutive Intramuscular (IM) injections of triptorelin 3.75 mg 28 days apart followed by the standard long protocol 28 days after the last injection.ResultsThere were no significant differences in the clinical and hormonal characteristics between the 2 groups. All ICSI cycle characteristics including number of retrieved oocytes, fertilized oocytes, and transferred embryos were also not significantly different. However, patients who received prolonged GnRH agonist therapy showed significantly higher chemical ( P = .011), clinical ( P = .018), and ongoing ( P = .028) pregnancy rates.ConclusionProlonged GnRH agonist downregulation improves the pregnancy rates in patients with small endometriomas undergoing ICSI.
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Abstract

Objective:To evaluate the effect of prolonged Gonadotropin releasing hormone (GnRH) agonist downregulation in patients with endometriomas of less than 5 cm on the outcome of the proceeding Intracytoplasmic sperm injection (ICSI) trial. Methods: In a randomized controlled trial at a university teaching hospital, 90 patients indicated for ICSI and having unilateral single endometrioma of less than 5 cm in diameter were randomized into 2 groups. Group A (45 patients) received the standard long protocol; whereas group B (45 patients) received 3 consecutive Intramuscular (IM) injections of triptorelin 3.75 mg 28 days apart followed by the standard long protocol 28 days after the last injection. Results: There were no significant differences in the clinical and hormonal characteristics between the 2 groups. All ICSI cycle characteristics including number of retrieved oocytes, fertilized oocytes, and transferred embryos were also not significantly different. However, patients who received prolonged GnRH agonist therapy showed significantly higher chemical (P = .011), clinical (P = .018), and ongoing (P = .028) pregnancy rates. Conclusion: Prolonged GnRH agonist downregulation improves the pregnancy rates in patients with small endometriomas undergoing ICSI. Similar content being viewed by others

References

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Effect of Prolonged GnRH Agonist Downregulation on ICSI Outcome in Patients With Endometriomas of Less Than 5 cm: A Randomized Controlled Trial. Reprod. Sci. 25, 1509–1514 (2018). https://doi.org/10.1177/1933719118756753 Published: Version of record: Issue date: DOI: https://doi.org/10.1177/1933719118756753

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endometriosis

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Endometriosis Gonadotropin-Releasing Hormone Pregnancy Outcome Sperm Injections, Intracytoplasmic Adult Down-Regulation Embryo Transfer Endometriosis Endometriosis Female Gonadotropin-Releasing Hormone Humans Oocyte Retrieval Pregnancy Pregnancy Rate Treatment Outcome Triptorelin Pamoate Triptorelin Pamoate

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