Hormonal Therapies before in vitro fertilization in women with endometriosis: The Minotaur's Labyrinth and the Ariadne's Thread

Antoine Naem, Harald Krentel, Gaby Moawad, Joelle Naem, Renato Venezia, Andrea Etrusco, Sanja Terzic, Antonio Simone Laganà
Best practice & research. Clinical obstetrics & gynaecology · 2024 · vol. 95 , pp. 102500 · doi:10.1016/j.bpobgyn.2024.102500 · PMID:38772765 · W4396721810
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This paper navigates the complex landscape of hormonal therapies used prior to in vitro fertilization for women with endometriosis, seeking an optimal treatment pathway.

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Abstract

Endometriosis-related infertility is one of the most debated topics in reproductive medicine. In recent years, prolonged pre-cycle hormonal regimens gained attention as a mean of improving the assisted reproduction technologies (ART) success rates in endometriosis patients. GnRH agonists, dienogest, medroxyprogesterone acetate, and aromatase inhibitors are the most studied medications. Conflicting results and a high risk of bias exist in almost all of the conducted studies in the field. However, current evidence suggests that pre-cycle treatment with GnRH agonists may be beneficial for patients with stage III/IV endometriosis. Dienogest and medroxyprogesterone acetate-based progestin-primed ovarian stimulation protocol was shown to be comparable to the prolonged GnRH agonists protocol. Finally, aromatase inhibitors seem to be of limited benefit to the assisted reproductive outcomes of endometriosis patients. Although it is challenging to draw any clinical conclusions, pre-cycle hormonal treatments seem to be best indicated in endometriosis patients who had previously failed ART treatment.

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Condition tags

endometriosis

MeSH descriptors

Aromatase Inhibitors Aromatase Inhibitors Aromatase Inhibitors Aromatase Inhibitors Aromatase Inhibitors Aromatase Inhibitors Aromatase Inhibitors Aromatase Inhibitors Aromatase Inhibitors Aromatase Inhibitors Aromatase Inhibitors Aromatase Inhibitors Aromatase Inhibitors Aromatase Inhibitors Aromatase Inhibitors Aromatase Inhibitors Aromatase Inhibitors Endometriosis Endometriosis Endometriosis

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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. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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