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12 June 2019 : Clinical Research  

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 Kong1ABEF, Zhiqin Bu1DEF, Yihong Guo1AD, Fang Wang1F, Hao Shi1CD, Linli Hu1F, Yingpu Sun1A*

DOI: 10.12659/MSM.916447

Med Sci Monit 2019; 25:4377-4383

Abstract

BACKGROUND: 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, Abortion, Spontaneous, Chorionic Gonadotropin, Down-Regulation, Embryo Transfer, Oocyte Retrieval, Oocytes, Ovulation Induction, Pituitary Gland, Pregnancy, Pregnancy Outcome, Sperm Injections, Intracytoplasmic

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750