Comparison of ovulation induction protocols after endometrioma resection.
OBJECTIVE
The aim of this study was to compare the in vitro fertilization (IVF) outcomes of long gonadotropin-releasing hormone agonist (GnRH-a) and GnRH-antagonist (GnRH-ant) protocols in endometriosis patients who have undergone laparoscopic endometrioma resection surgery. To our knowledge, there is no study in the current literature that compares the effectiveness of long GnRH-a and GnRH-ant protocols in management of IVF cycles in endometriosis patients who underwent laparoscopic endometrioma resection surgery.


METHODS
Eighty-six patients with stage III to IV endometriosis who had undergone laparoscopic resection surgery for endometrioma were divided into 2 groups: those who had ovarian stimulation with a long GnRH-a protocol (n=44), and those who had ovarian stimulation with a GnRH-ant protocol (n=42).


RESULTS
The number of follicles on human chorionic gonadotropin injection day, duration of hyperstimulation, number of retrieved metaphase II oocytes, and total number of grade 1 embryos were statically significantly higher in the long GnRH-a protocol. There were no significant differences in positive β-human chorionic gonadotropin pregnancy rates (25% vs 21.4%; P=.269) and ongoing pregnancy rates per patient (20.5% vs 19.1%; P=.302) between the 2 protocols.


CONCLUSIONS
Long GnRH-a and GnRH-ant protocols both present similar IVF outcomes in patients with endometriosis who have undergone laparoscopic endometrioma resection surgery. A long GnRH-a protocol may lead to a higher number of embryos that can be cryopreserved, providing the possibility of additional embryo transfers without having to go through the process of ovarian stimulation again.
Department of Obstetrics and Gynecology, Istanbul University School of Medicine, Istanbul, Turkey.
Ercan
E
Bastu
Department of Obstetrics and Gynecology, Istanbul University School of Medicine, Istanbul, Turkey.
Cenk
C
Yasa
Department of Obstetrics and Gynecology, Istanbul University School of Medicine, Istanbul, Turkey.
Ozlem
O
Dural
Department of Obstetrics and Gynecology, HRS Women Hospital, Kavaklidere, Ankara, Turkey.
Mehmet Firat
MF
Mutlu
Department of Obstetrics and Gynecology, Istanbul University School of Medicine, Istanbul, Turkey.
Cem
C
Celik
Department of Obstetrics and Gynecology, Istanbul University School of Medicine, Istanbul, Turkey.
Funda Gungor
FG
Ugurlucan
Department of Obstetrics and Gynecology, Istanbul University School of Medicine, Istanbul, Turkey.
Faruk
F
Buyru
D000293:Adolescent; D000328:Adult; D016889:Endometrial Neoplasms / Q000601:surgery; D004715:Endometriosis / Q000601:surgery*; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use; D005307:Fertilization in Vitro / Q000379:methods*; D007987:Gonadotropin-Releasing Hormone / Q000187:drug effects* / Q000378:metabolism; D006801:Humans; D016729:Leuprolide / Q000627:therapeutic use*; D008186:Luteolytic Agents / Q000627:therapeutic use; D010062:Ovulation Induction / Q000379:methods*; D011182:Postoperative Care / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate / Q000639:trends; D017329:Triptorelin Pamoate / Q000627:therapeutic use*; D055815:Young Adult
D005300:Fertility Agents, Female; D008186:Luteolytic Agents; D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone; D016729:Leuprolide
GnRH agonist; GnRH antagonist; Laparoscopic endometrioma resection; in vitro fertilization; intracytoplasmic sperm injection