The Role of Intrauterine Insemination in the Therapy of Infertile Women with Endometriosis

J. Daru, Attila Keresztúri, János Szöllõsi, S Koloszár, Attila Pál
In: Journal of Endometriosis · 2011 · vol. 3(2) , pp. 93–98 · doi:10.5301/je.2011.8529 · W2093072518
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The combined approach of laparoscopic surgery, GnRH analogue therapy, and controlled ovarian hyperstimulation-intrauterine insemination achieved a 51.6% pregnancy rate in infertile women with endometriosis, exceeding rates from surgery and GnRH analogue therapy alone.

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Abstract

Purpose Laparoscopy is considered the gold standard for the diagnosis and treatment of endometriosis. Controlled ovarian hyperstimulation-intrauterine insemination (COH-IUI) is often used to treat women with infertility associated with endometriosis. The objective of the study was to assess the pregnancy rate following surgery, and 6 month GnRH analogue (GnRH-a) therapy, and to assess whether a combined approach with laparoscopic surgery and GnRH-a followed by COH-IUI can improve the overall pregnancy rate. Methods A prospective study was performed on 119 infertile patients who underwent laparoscopic surgery and GnRH-a therapy for endometriosis and returned for a follow-up for a period of time between one and 10 years. Results The pregnancy rate attained after the integrated laparoscopy–GnRH-a–COH-IUI approach was 51.6%. The pregnancy rate after surgery and GnRH-a therapy was significantly lower (41.8%). The fecundity rate for spontaneous conception within 6 months of laparoscopy and GnRH-a treatment (27%) was significantly higher (P<.05) than for the following intervals. Cumulative fecundity in women aged older than 35 was significantly lower than in younger women. Conclusions In patients with endometriosis-associated infertility, surgery and GnRH-a therapy followed by COH-IUI is more effective than surgery and GnRH-a therapy. When patients fail to conceive spontaneously, after a maximum of one year following laparoscopic surgery and GnRH-a, COH-IUI or In Vitro Fertilization Embryo Transfer (IVF-ET) should be recommended.

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Condition tags

endometriosisinfertility

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (11)

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