title: Efficacy of the Levonorgestrel-Releasing Intrauterine System on IVF-ET Outcomes in PCOS With Simple Endometrial Hyperplasia.
abstract: OBJECTIVE
  This study investigated the in vitro fertilization (IVF) outcome of levonorgestrel-releasing intrauterine system (LNG-IUS) pretreatment for simple endometrial hyperplasia (EH) in patients with polycystic ovary syndrome (PCOS) undergoing IVF embryo transfer (IVF-ET).
  
  
  METHODS
  One hundred ninety patients with PCOS and simple EH without cytologic atypia were allocated randomly to 2 independent arms, that is, the LNG-IUS group (90 patients) and the non-LNG-IUS group (100 patients). Four hundred fourteen patients with PCOS without endometrial disease comprised the control group. Each patient was reevaluated by transvaginal ultrasonography (TVS) and endometrial biopsy after 6 months. For each patient, IVF outcome measures, such as number of recombinant follicle-stimulating hormone, endometrial thickness on human chorionic gonadotropin (HCG) day, hormone levels (progesterone, luetinizing hormone, and serum estradiol) on HCG day, number of oocytes, fertilization rate, clinical pregnancy rate, and miscarriage rate were compared among the 3 groups.
  
  
  RESULTS
  In general, the 3 groups did not differ with respect to the main clinical and biochemical data. After 6 months, patients in LNG-IUS group had an EH resolution rate of 87.77%. In the non-LNG-IUS group, the resolution rate was 15.00%, and 3% of these patients showed progression of EH. The clinical pregnancy rates in the non-LNG-IUS group were significantly lower (28.04%) than that in the LNG-IUS group (46.06%) and the control group (44.65%). The miscarriage rate was highest in the non-LNG-IUS group, but no significant difference in miscarriage rate existed among the 3 groups.
  
  
  CONCLUSIONS
  The study illustrates that the LNG-IUS can be safely used for 6 months as a treatment for patients with PCOS and simple EH. Additionally, use of the LNG-IUS can increase the clinical pregnancy rates and implantation rates of patients with PCOS and simple EH who undergo gonadotropin-releasing hormone agonist IVF-ET protocols.
authors.affiliation: Department of Obstetrics and Gynecology, The Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, China Department of Obstetrics and Gynecology, Jingzhou Central Hospital, Jingzhou, China.
authors.forename: Jiang
authors.initials: J
authors.lastname: Bian
authors.affiliation: Department of Obstetrics and Gynecology, The Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, China.
authors.forename: Hongfang
authors.initials: H
authors.lastname: Shao
authors.affiliation: Department of Obstetrics and Gynecology, Jingzhou Central Hospital, Jingzhou, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Obstetrics and Gynecology, Jingzhou Central Hospital, Jingzhou, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Obstetrics and Gynecology, The Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Fang
authors.affiliation: Department of Obstetrics and Gynecology, The Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, China.
authors.forename: Changying
authors.initials: C
authors.lastname: Xing
authors.affiliation: Department of Obstetrics and Gynecology, The Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, China.
authors.forename: Lihong
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Obstetrics and Gynecology, The Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, China taomf@126.com.
authors.forename: Minfang
authors.initials: M
authors.lastname: Tao
mesh_terms: D000022:Abortion, Spontaneous / Q000209:etiology; D000328:Adult; D001706:Biopsy; D002681:China; D010064:Embryo Implantation / Q000187:drug effects; D004624:Embryo Transfer / Q000009:adverse effects; D004714:Endometrial Hyperplasia / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage* / Q000009:adverse effects; D005307:Fertilization in Vitro / Q000009:adverse effects; D006801:Humans; D007247:Infertility, Female / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D007436:Intrauterine Devices, Medicated / Q000009:adverse effects; D016912:Levonorgestrel / Q000008:administration & dosage* / Q000009:adverse effects; D011085:Polycystic Ovary Syndrome / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D005300:Fertility Agents, Female; D016912:Levonorgestrel
keywords: IVF; endometrial hyperplasia; levonorgestrel-releasing intrauterine system; polycystic ovary syndrome