title: Endometriosis and IVF: are agonists really better? Analysis of 1180 cycles with the propensity score matching.
abstract: OBJECTIVE
  To compare the outcomes of patients with confirmed endometriosis undergoing in vitro fertilization (IVF)-embryo transfer (ET) treated with either gonadotropin-releasing hormone agonist (GnRHa) or gonadotropin-releasing hormone antagonist (GnRHant) using the propensity score (PS) matching.
  
  
  METHODS
  Observational, retrospective analysis from January 2000 to December 2010.
  
  
  METHODS
  Private tertiary fertility clinic.
  
  
  METHODS
  Patients with endometriosis confirmed by ultrasound or surgery (American Fertility Society; AFS grades I-IV) that underwent an IVF-ET, stimulated with standard controlled ovarian hyperstimulation (COH) and GnRHa or GnRHant.
  
  
  METHODS
  A PS was assigned to all patients, which calculates the conditional probability of receiving a certain treatment; a higher PS (1) meant a higher probability of receiving treatment with GnRHa, and a lower PS (0) meant a higher probability of receiving GnRHant. The PS was calculated with a logistic regression model adjusted specifically for age, follicle stimulating hormone, antral follicle count and previous IVF cycles. All patients were divided into three groups according to their PS.
  
  
  METHODS
  pregnancy rate (PR) per cycle.
  
  
  RESULTS
  1180 patients were analyzed. Raw PR per cycle was 41.8% and 23.4%, and PR per ET was 44.3 and 27%, respectively. PR per cycle: 41.9 versus 30% in group A; in group B, 39.7% versus 36.4% and in group C, 15.4% versus 18.9%. The overall odds ratio for PR adjusted by PS was 1.10 [0.58-2.19].
  
  
  CONCLUSIONS
  After matching patients by PS, PR after COH with either GnRHa or GnRHant may be equally effective.
authors.affiliation: Department of Gynecology, Obstetrics and Reproductive Medicine, Institut Universitari Dexeus, Gran Vía de Carlos III, Barcelona, 08028 Spain. jorgerdzpurata@gmail.com
authors.forename: Jorge
authors.initials: J
authors.lastname: Rodriguez-Purata
authors.forename: Buenaventura
authors.initials: B
authors.lastname: Coroleu
authors.forename: Rosa
authors.initials: R
authors.lastname: Tur
authors.forename: Beatriz
authors.initials: B
authors.lastname: Carrasco
authors.forename: Ignacio
authors.initials: I
authors.lastname: Rodriguez
authors.forename: Pedro Nolasco
authors.initials: PN
authors.lastname: Barri
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D004624:Embryo Transfer; D004715:Endometriosis / Q000150:complications / Q000628:therapy*; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D005307:Fertilization in Vitro / Q000379:methods*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists* / Q000037:antagonists & inhibitors; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000628:therapy*; D010062:Ovulation Induction / Q000379:methods; D011247:Pregnancy; D018873:Pregnancy Rate; D057216:Propensity Score; D012189:Retrospective Studies
chemical_list: D005300:Fertility Agents, Female; D007987:Gonadotropin-Releasing Hormone