Role of suppression of endometriosis with progestins before IVF-ET: a non-inferiority randomized controlled trial

BMC Pregnancy and Childbirth

Hashem Mohammad¹  Ameer Abdullah¹  Eissa Khalifa¹  Mohammed Khairy¹  Mahmoud Hosni¹  Mazen Abdel-Rasheed² 

[1] Obstetrics and Gynecology Department, Faculty of Medicine, Minia University, Minia, Egypt;Reproductive Health Research Department, National Research Centre, 33 El-Buhouth St, Dokki, 12622, Cairo, Egypt;

关键词: Endometriosis;    IVF-ICSI;    Dienogest;    Progestins;    GnRH-analogue;   

DOI  :  10.1186/s12884-021-03736-2

来源: Springer

【 摘 要 】

BackgroundEndometriosis affects the responsiveness to ovarian stimulation. This study aimed to assess the role of Dienogest pretreatment for endometriosis suppression as compared to Gonadotropin-releasing hormone agonist (GnRHa) in patients with endometriosis pursuing IVF treatment.MethodsIn this randomized controlled trial, 134 women with endometriosis-related infertility were randomly allocated to group A (n = 67) who had monthly depot GnRHa for 3 months before ovarian stimulation in IVF treatment (Ultra-long protocol), and Group B (n = 67) who had daily oral Dienogest 2 mg/d for 3 months before starting standard long protocol for IVF. The primary outcome measure was the number of oocytes retrieved. The secondary outcome measures included the number of mature oocytes, fertilization rate, quality of life assessed by FertiQoL scores, cost of treatment, and pregnancy outcomes.ResultsAlthough there was no statistically significant difference between both groups regarding ovarian stimulation, response parameters, and pregnancy outcomes, the Dienogest group had a lower cost of treatment (2773 vs. 3664 EGP, P < 0.001), lower side effects (29.9% vs. 59.7%, P < 0.001), higher FertiQoL treatment scores (33.2 vs. 25.1, P < 0.001) and higher tolerability scores (14.1 vs. 9.4, P < 0.001 < 0.001).ConclusionOur study indicates that Dienogest is a suitable and safe substitute for GnRHa pretreatment in endometriosis patients.Trial registrationNCT04500743 “Retrospectively registered on August 5, 2020”.

【 授权许可】

CC BY