Experience with a depot GnRH-agonist (Zoladex) in the treatment of genital endometriosis.
Eighty patients with different stages of genital endometriosis were treated with Zoladex, a gonadotrophin-releasing hormone analogue in a depot formulation, injected subcutaneously every 4 weeks. The stages of endometriosis (I-IV) were classified according to the revised American Fertility Society recommendations (AFS criteria) via pelviscopy before and after 6 months of treatment. Fifty-eight second-look pelviscopies were performed with the following objective changes after (before) treatment: Stage IV 0 (3); Stage III, 2 (13); Stage II, 12 (30); Stage I, 19 (12). Twenty-five patients presented with Stage 0 after therapy and were healed. All 57 symptomatic patients showed a subjective response to Zoladex therapy with a significant decrease of the total pelvic symptom score. Thirty-eight patients with infertility wished to become pregnant and so far 16 (40%) have conceived. During therapy, the serum concentrations of luteinizing hormone, follicle stimulating hormone, estradiol and progesterone were significantly suppressed. All patients were amenorrhoeic after 1-2 injections. Restoration of ovarian function with resumption of menstruation occurred within 57-92 days after the last injection of Zoladex (1-2 months after end of treatment). Side-effects were minimal and were those expected of the hypo-oestrogenic state, such as hot flushes, vaginal dryness and decrease of libido.
Mettler
L
L
Department of Obstetrics and Gynaecology, University of Kiel, Heidelberg, Germany.
Steinmüller
H
H
Schachner-Wünschmann
E
E
D000328:Adult; D002064:Buserelin / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D003692:Delayed-Action Preparations; D004715:Endometriosis / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy*; D004958:Estradiol / Q000032:analysis; D005260:Female; D017273:Goserelin; D006801:Humans; D007986:Luteinizing Hormone / Q000032:analysis; D011247:Pregnancy; D011256:Pregnancy Outcome; D011374:Progesterone / Q000032:analysis; D011388:Prolactin / Q000032:analysis; D013739:Testosterone / Q000032:analysis
D003692:Delayed-Action Preparations; D017273:Goserelin; D013739:Testosterone; D011374:Progesterone; D004958:Estradiol; D011388:Prolactin; D007986:Luteinizing Hormone; D002064:Buserelin