Short-term postoperative GnRH analogue or danazol treatment after conservative surgery for stage III or IV endometriosis before ovarian stimulation: a prospective, randomized study.
OBJECTIVE
To assess the effect of short-term use of a gonadotropin releasing hormone (GnRH) analogue for 3 months before ovarian stimulation in patients with stage III and IV endometriosis after conservative surgery.


METHODS
Eleven patients were randomly selected to receive intramuscular injections of GnRH analogue, leuprolide acetate (3.75 mg), every 28 days, or 400 mg danazol orally 2 times per day for 3 months before ovarian stimulation after conservative laparoscopic or laparotomy surgeryfor stage III and IV symptomatic endometriosis (group 1), as compared with 30 patients who had received no postoperative treatment with GnRH analogue or danazol but underwent ovarian stimulation immediately after thefirst menses within 3 months postoperatively (group 2).


RESULTS
Although the number of oocytes retrieved and number of embryos per cycle were significantly higher in group 1, the pregnancy rate per cycle in group 1 was not significantly different from that in group 2 (18% vs. 20%). The cumulative pregnancy rate at 12 months was 54.5% and 56.7% in group 1 and group 2, respectively. With regard to recurrence of disease after 24 months of follow-up, group 2 had a statistically significantly higher recurrence rate (13.3%) than did group 1 (0%).


CONCLUSIONS
Short-term use of GnRH analogue before ovarian stimulation in women with stage III or IV endometriosis confers no definite benefits on pregnancy rates per cycle when compared with patients who received ovarian stimulation within 3 months after conservative surgery.
Tsai
Yieh-Loong
YL
Departments of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
Hwang
Jiann-Loung
JL
Loo
Tao-Chuan
TC
Cheng
Wei-Chi
WC
Chuang
Jesse
J
Seow
Kok-Min
KM
D000328:Adult; D003613:Danazol / Q000627:therapeutic use*; D004715:Endometriosis / Q000188:drug therapy* / Q000601:surgery; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D006801:Humans; D016729:Leuprolide / Q000627:therapeutic use*; D010062:Ovulation Induction / Q000379:methods*; D011184:Postoperative Period; D011247:Pregnancy; D018873:Pregnancy Rate; D011300:Preoperative Care; D011446:Prospective Studies
D005300:Fertility Agents, Female; D016729:Leuprolide; D003613:Danazol