Does Controlled Ovarian Hyperstimulation in Women with a History of Endometriosis Influence Recurrence Rate?

Maria Elisabetta Coccia, Francesca Rizzello, Gianfranco Scarselli, Scarselli Gianfranco
Journal of women's health (2002) · 2010 · vol. 19(11) , pp. 2063–2069 · doi:10.1089/jwh.2009.1914 · PMID:20831441 · W2072892930
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Controlled ovarian hyperstimulation for assisted reproductive technology did not increase endometriosis recurrence rates compared to a control group, suggesting gonadotropin treatments do not alter endometriotic lesion progression.

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Abstract

BACKGROUND: Endometriosis is a common estrogen-dependent disease. The aim of this study was to assess whether controlled ovarian hyperstimulation (COH) for assisted reproductive technology (ART) was associated with an increased incidence in endometriosis recurrence as documented by transvaginal ultrasound (TV-US). METHODS: In a retrospective cohort study of 592 patients submitted to laparoscopy for endometriosis, 177 with infertility-related endometriosis who underwent a periodic ultrasound follow-up after laparoscopy were selected. Women who started ART after laparoscopy (n = 90) were compared with the control group, who did not undergo ART (n = 87). Recurrence of endometriosis was defined as the presence of endometriotic lesions observed through TV-US. RESULTS: During a long-term TV-US follow-up (1-15 years), 40 (22.6%) recurrences were observed. Patients submitted to ART showed a cumulative recurrence rate similar to that of the control group (28.6% and 37.9% respectively, p = 0.471). Recurrent lesions were ovarian cysts (47.5%), ovarian nodules (37.5%), and rectovaginal disease (15%). The stratified analysis based on stages of endometriosis and pelvic pain did not show differences. CONCLUSIONS: Gonadotropin treatments do not seem to affect the natural history of endometriotic lesions. The most important prognostic factors in recurrent disease observed by TV-US seem to be the stage of endometriosis and the presence of pelvic pain at the time of the first laparoscopic treatment.

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Condition tags

endometriosisinfertility

MeSH descriptors

Chorionic Gonadotropin Endometriosis Infertility, Female Ovulation Induction Adult Chorionic Gonadotropin Chorionic Gonadotropin Cohort Studies Endometriosis Endometriosis Female Follicle Stimulating Hormone Follicle Stimulating Hormone Follow-Up Studies Humans Infertility, Female Infertility, Female Injections, Subcutaneous Laparoscopy Ovulation Induction

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