Efficacy and Safety of In Vitro Fertilization (IVF)/Intracytoplasmic Sperm Injection (ICSI) Among Patients with Endometriosis After a Shortened Protocol of Long-Term Pituitary Downregulation
Huijuan Kong, Zhiqin Bu, Yihong Guo, Fang Wang, Hao Shi, Linli Hu, Yingpu Sun
Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, and Henan Province Key Laboratory of Reproduction and Genetics, Zhengzhou, Henan, China (mainland)
Med Sci Monit 2019; 25:4377-4383
Patients with endometriosis (EMs) are routinely advised to take GnRH-a for 3-6 months to improve the internal reproductive environment, but this may not be necessary.
MATERIAL AND METHODS: This retrospective study examined the effects of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) with shortened (n=311) or conventional (n=213) long-term pituitary downregulation in EMs patients between January 2013 and July 2017.
RESULTS: The 2 groups showed no significant differences in gonadotropin (Gn) dose, number of oocytes retrieved, or miscarriage rate. Follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) levels on the initiation day and the LH level on human chorionic gonadotropin (hCG) day (1.22±1.39 vs. 0.74±0.55 P=0.0026) were higher in the study group than in the control group. The cumulative live birth rates in the second cycle were 69.13% in the study group (95% confidence interval (CI), 64-74.27%) vs. 68.54% in the control group (95% CI, 62.31-74.78%, P=0.88, respectively).
CONCLUSIONS: This study showed that the shortened regimen and the ultralong regimen did not produce different pregnancy outcomes after ART, and the single-application, long-term GnRH-a protocol may serve as a cost-effective and safe treatment protocol for EMs patients.
Keywords: Endometriosis, Fertilization in Vitro, Gonadotropin-Releasing Hormone, Pregnancy Rate