Efficacy and Safety of In Vitro Fertilization (IVF)/Intracytoplasmic Sperm Injection (ICSI) Among Patients with Endometriosis After a Shortened Protocol of Long-Term Pituitary Downregulation

Huijuan Kong, Zhiqin Bu, Yihong Guo, Wang Fang, Hao Shi, Linli Hu, Yingpu Sun
In: Medical Science Monitor · 2019 · vol. 25 , pp. 4377–4383 · doi:10.12659/msm.916447 · W2953020336
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-06 ⓘ

This retrospective study found that a shortened pituitary downregulation protocol before IVF/ICSI yielded similar pregnancy outcomes and safety profiles compared to a conventional long-term protocol in patients with endometriosis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-06 · read from full text ⓘ

This retrospective study compared IVF/ICSI outcomes in 524 patients with endometriosis who received either a shortened or conventional long-term pituitary downregulation protocol, using data from January 2013 to July 2017. The authors found no significant differences between groups in gonadotropin dose, number of oocytes retrieved, or miscarriage rate, and reported similar cumulative live birth rates by the second cycle (69.13% vs 68.54%, P=0.88), while certain hormone levels (FSH, LH, and estradiol on initiation day, and LH on hCG day) were higher in the shortened-protocol group; a key limitation is the retrospective design. This paper is centrally about endometriosis — it evaluates whether shortened versus ultralong GnRH-a downregulation affects IVF/ICSI efficacy and safety in patients with endometriosis.

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Abstract

BACKGROUND: Patients with endometriosis (EMs) are routinely advised to take GnRH-a for 3–6 months to improve the internal reproductive environment, but this may not be necessary. MATERIAL/METHODS: This retrospective study examined the effects of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) with shortened (n=311) or conventional (n=213) long-term pituitary downregulation in EMs patients between January 2013 and July 2017. RESULTS: The 2 groups showed no significant differences in gonadotropin (Gn) dose, number of oocytes retrieved, or miscarriage rate. Follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) levels on the initiation day and the LH level on human chorionic gonadotropin (hCG) day (1.22±1.39 vs. 0.74±0.55 P=0.0026) were higher in the study group than in the control group. The cumulative live birth rates in the second cycle were 69.13% in the study group (95% confidence interval (CI), 64–74.27%) vs. 68.54% in the control group (95% CI, 62.31–74.78%, P=0.88, respectively). CONCLUSIONS: This study showed that the shortened regimen and the ultralong regimen did not produce different pregnancy outcomes after ART, and the single-application, long-term GnRH-a protocol may serve as a cost-effective and safe treatment protocol for EMs patients.
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Abstract

BACKGROUND: Patients with endometriosis (EMs) are routinely advised to take GnRH-a for 3–6 months to improve the internal reproductive environment, but this may not be necessary.

Material and methods

This retrospective study examined the effects of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) with shortened (n=311) or conventional (n=213) long-term pituitary downregulation in EMs patients between January 2013 and July 2017.

Results

The 2 groups showed no significant differences in gonadotropin (Gn) dose, number of oocytes retrieved, or miscarriage rate. Follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) levels on the initiation day and the LH level on human chorionic gonadotropin (hCG) day (1.22±1.39 vs. 0.74±0.55 P=0.0026) were higher in the study group than in the control group. The cumulative live birth rates in the second cycle were 69.13% in the study group (95% confidence interval (CI), 64–74.27%) vs. 68.54% in the control group (95% CI, 62.31–74.78%, P=0.88, respectively).

Conclusions

This study showed that the shortened regimen and the ultralong regimen did not produce different pregnancy outcomes after ART, and the single-application, long-term GnRH-a protocol may serve as a cost-effective and safe treatment protocol for EMs patients.

Keywords

Endometriosis, Fertilization in Vitro, Gonadotropin-Releasing Hormone, Pregnancy Rate, Abortion, Spontaneous, Chorionic Gonadotropin, Down-Regulation, Embryo Transfer, Oocyte Retrieval, Oocytes, Ovulation Induction, Pituitary Gland, Pregnancy, Pregnancy Outcome, Sperm Injections, Intracytoplasmic Editorial 01 January 2026 : Editorial Editorial: Increasing Awareness of Lung Cancer in Non-Smokers and Never-Smokers Challenges Current Approaches to Prevention and ScreeningDOI: 10.12659/MSM.952454 Med Sci Monit 2026; 32:e952454 In Press Clinical Research Institutional and Regional Variations in Access to Clinical Trials and Next-Generation Sequencing in Turkis...Med Sci Monit In Press; DOI: 10.12659/MSM.951027 Clinical Research Low-Intensity Blood Flow-Restricted Multi-Joint Exercise Improves Muscle Function in Patients With Patellof...Med Sci Monit In Press; DOI: 10.12659/MSM.950516 Review article Musculoskeletal Ultrasound and MRI in the Evaluation of Chemotherapy-Induced Peripheral Neuropathy: A ReviewMed Sci Monit In Press; DOI: 10.12659/MSM.951283 Clinical Research Sensory Processing, Dissociation, and Affective Symptoms in Misophonia: A Cross-Sectional Study of 35 AdultsMed Sci Monit In Press; DOI: 10.12659/MSM.950938 Most Viewed Current Articles 17 Jan 2024 : Review article 10,187,196 Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron VariantDOI :10.12659/MSM.942799 Med Sci Monit 2024; 30:e942799 13 Nov 2021 : Clinical Research 3,708,487 Acceptance of COVID-19 Vaccination and Its Associated Factors Among Cancer Patients Attending the Oncology ...DOI :10.12659/MSM.932788 Med Sci Monit 2021; 27:e932788 14 Dec 2022 : Clinical Research 2,341,643 Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase LevelsDOI :10.12659/MSM.937990 Med Sci Monit 2022; 28:e937990 16 May 2023 : Clinical Research 706,524 Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...DOI :10.12659/MSM.940387 Med Sci Monit 2023; 29:e940387

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