Impact of dienogest pretreatment on IVF-ET outcomes in patients with endometriosis: a systematic review and meta-analysis

Wenjing Shao, Yuying Li, Yanli Wang
Journal of ovarian research · 2023 · vol. 16(1) , pp. 166 · doi:10.1186/s13048-023-01245-8 · PMID:37587520 · W4385874469
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This meta-analysis found dienogest pretreatment had similar IVF-ET outcomes to non-dienogest pretreatment, but significantly improved clinical pregnancy and live birth rates compared to non-hormonal treatment for fresh embryo transfers.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This paper systematically reviewed and meta-analyzed studies (through September 14, 2022) comparing dienogest (DNG) pretreatment versus non-DNG pretreatment before IVF-ET in women with endometriosis, assessing clinical pregnancy rate and live birth rate as primary outcomes and multiple IVF/embryology measures as secondary outcomes. Across five studies including 568 participants, DNG showed similar effects to non-DNG on most IVF-ET outcomes (all P > 0.05), but had a higher clinical pregnancy rate than non-hormonal treatment and a lower clinical pregnancy rate than long GnRH-a; live birth rate was higher versus non-hormonal treatment and lower versus long GnRH-a. The authors note that “more evidence is warranted to corroborate these findings,” implying limited data supporting definitive conclusions. This paper is centrally about endometriosis—specifically, evaluating whether dienogest pretreatment before IVF-ET improves clinical pregnancy and live birth outcomes.

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Abstract

BACKGROUND: To comprehensively evaluate the influence of dienogest (DNG) versus non-DNG pretreatment on in vitro fertilization and embryo transfer (IVF-ET) outcomes for patients with endometriosis. METHODS: PubMed, Embase, Cochrane Library, Web of Science, CNKI, WanFang, and VIP were comprehensively searched for relevant publications until September 14, 2022. Primary outcomes included clinical pregnancy rate and live birth rate. Secondary outcomes included retrieved oocytes, mature oocytes, blastocysts, growing follicles, transferrable embryos, fertilization rate, implantation rate, and miscarriage rate. Subgroup analysis was performed according to different grouping methods and embryo types. RESULTS: Five studies of 568 females with endometriosis were involved in this systematic review and meta-analysis. DNG treatment exhibited similar effects to non-DNG treatment on either the primary or the secondary outcomes (all P > 0.05). The DNG group had a significantly greater clinical pregnancy rate than the non-hormonal treatment group (pooled relative risk [RR]: 2.055, 95% confidence interval [CI]: 1.275, 3.312, P = 0.003), and exhibited a significantly lower clinical pregnancy rate than the long gonadotropin-releasing hormone agonist (GnRH-a) group (RR: 0.542, 95%CI: 0.321, 0.916, P = 0.022). For patients undergoing fresh embryo transfer, the DNG group displayed a significantly greater clinical pregnancy rate versus the non-DNG group (pooled RR: 1.848, 95%CI: 1.234, 2.767, P = 0.003). Patients receiving DNG had a significantly greater live birth rate than those with non-hormonal treatment (pooled RR: 2.136, 95%CI: 1.223, 3.734, P = 0.008), while having a significantly lower live birth rate than the long GnRH-a group (RR: 0.441, 95%CI: 0.214, 0.907, P = 0.026). While using fresh embryos, patients with DNG treatment had an increased live birth rate, compared with those without DNG treatment (pooled RR: 2.132, 95%CI: 1.090, 4.169, P = 0.027). CONCLUSION: DNG treatment may have similar effects to non-DNG treatment on IVF-ET outcomes. The clinical pregnancy rate and live birth rate after DNG treatment may be significantly higher than those after non-hormonal treatment. More evidence is warranted to corroborate these findings.

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Birth Rate Birth Rate Birth Rate Birth Rate Birth Rate Birth Rate Birth Rate Birth Rate Female Female Female

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