High rates of pregnancy after long-term down-regulation of women with severe endometriosis

Marcus SF, Samuel F. Marcus, S F Marcus, Edwards RG, R. G. EDWARDS
American journal of obstetrics and gynecology · 1994 · vol. 171(3) , pp. 812–817 · doi:10.1016/0002-9378(94)90103-1 · PMID:8092234 · W1964986953
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This study investigated the pregnancy rates in women with severe endometriosis who underwent long-term down-regulation treatment.

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Abstract

ObjectiveThe purpose of this study was to determine the effects of pituitary down-regulation for several months on the outcome of in vitro fertilization treatment in women with severe endometriosis.Study designA total of 84 patients with severe endometriosis (grades III and IV) were recruited in a semirandomized prospective study; 69 of these were controls who were given a short protocol with gonadotropin-releasing hormone agonist followed by human menopausal gonadotropin and human chorionic gonadotropin to induce follicular growth. Fifteen treated patients underwent down-regulation for 2 to 7 months and then human menopausal gonadotropin and human chorionic gonadotropin to induce follicular growth. Twenty nonpregnant controls after in vitro fertilization were treated in a similar manner.ResultsThe pregnancy rates were much high per embryo transfer, 18 of 42 (42.8%), especially in patients in whom in vitro fertilization was carried out during the fourth month of down-regulation. Pregnancy rates in the control group were 17 of 134 (12.7%) (p < 0.001).ConclusionHigher rates of pregnancy are achieved after in vitro fertilization that follows long-term down-regulation in women with extensive endometriosis.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Gonadotropin-Releasing Hormone Pituitary Gland Pregnancy Adult Analysis of Variance Chorionic Gonadotropin Chorionic Gonadotropin Down-Regulation Endometriosis Female Fertilization in Vitro Gonadotropin-Releasing Hormone Humans Menotropins Menotropins Pituitary Gland Pregnancy Pregnancy Outcome Prospective Studies

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