Postoperative long-term maintenance therapy with oral contraceptives after gonadotropin-releasing hormone analog treatment in women with ovarian endometrioma

STUDY OBJECTIVE: The goal of this preliminary study was to assess the effect of cyclic monophasic oral contraceptives (OCs) as a postoperative long-term maintenance therapy (median 33.2 months) to suppress recurrence of endometrioma after conservative ovarian surgery followed by gonadotropin-releasing hormone (GnRH) analog treatment. DESIGN: Retrospective clinical study (Canadian Task Force classification II-2). SETTING: Adolescent and premarital clinic in a university hospital. PATIENTS: The study was performed on 51 patients who underwent conservative surgery for endometrioma followed by GnRH analog treatment for 6 months. INTERVENTIONS: We used cyclic monophasic OCs as maintenance therapy after surgical and medical treatment with GnRH analog for 6 months. MEASUREMENTS AND MAIN RESULTS: Cyclic monophasic OCs were offered to young patients (n=51, age=24.1+/-2.8 years) who did not want to conceive immediately, to prevent the recurrence of endometrioma after conservative surgery with 6 cycles of postoperative GnRH analog treatment. During the long-term follow-up period (median 41.2; range 19-94 months), no recurrences of the endometrioma occurred in the current OC users. One patient showed a recurrence of endometrioma at 12 months after the discontinuation of the OCs. The median duration of OC administration was 33.20 months (range 12-86). In addition, 4 of 10 patients became pregnant within 12 months of discontinuing the long-term OC therapy. CONCLUSION: Postoperative long-term maintenance therapy with OCs can effectively suppress endometrioma recurrence in adolescent and young patients.