Pretreatment with gonadotrophin releasing hormone (GnRH) analogue prior to in vitro fertilisation for patients with endometriosis.
To assess the effect of GnRH pretreatment prior to IVF-ET on fertilisation and pregnancy rates in patients with endometriosis compared with tubal infertility, a retrospective analysis of 228 cycles of tubal infertility cases (Group 1) and 92 cycles of endometriosis has been performed. Patients with endometriosis were classified by the revised AFS scoring system to two groups: 37 cycles of minimal and mild endometriosis (Group 2) and 55 cycles of moderate and severe endometriosis (Group 3). The GnRH analogue buserelin was used for pituitary desensitisation in all IVF cycles. Endometriosis patients have a minimum of 6 weeks GnRH treatment prior to superovulation therapy. Although the fertilisation rate per oocyte (51%) was significantly lower in Group 3 (P < 0.001), the percentage of cycles in which fertilisation occurred (86%, 78%, 78%) and the pregnancy rates per embryo transfer (17.7%, 17.2%, 18.6%) for Groups 1, 2 and 3, respectively, were not significantly different. Pretreatment with GnRH analogues allows patients with endometriosis to achieve similar success rates to patients with tubal infertility alone.
Curtis
P
P
University Department of Obstetrics and Gynaecology, Royal Free Hospital School of Medicine, Hampstead, London, UK.
Jackson
A
A
Bernard
A
A
Shaw
R W
RW
D000328:Adult; D002064:Buserelin / Q000627:therapeutic use*; D004715:Endometriosis / Q000188:drug therapy*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D012189:Retrospective Studies
D002064:Buserelin