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Gazzetta Medica Italiana - Archivio per le Scienze Mediche 2020 May;179(5):342-7

DOI: 10.23736/S0393-3660.19.04108-1


lingua: Inglese

Endometriosis related infertility. Analysis of IVF/ICSI outcome: should GNRH analogue be integrated with control ovarian stimulation?

Ridzuan JAMALUDIN 1, 2 , Murizah MOHD ZAIN 1, Chan HUAN KEAT 2, Mohd F. AHMAD 3

1 Reproduction Unit, Department of Obstetrics and Gynecology, Sultanah Bahiyah Hospital, Alor Setar, Malaysia; 2 Clinical Research Center, Hospital Sultanah Bahiyah, Alor Setar, Malaysia; 3 Unit of Medical Assisted Conception, University of Malaysia Hospital, Kuala Lumpur, Malaysia

BACKGROUND: The aim of this study was to evaluate the IVF/ICSI outcome in endometriosis patient who received GnRH analog as downregulation prior control ovarian stimulation (COH).
METHODS: A retrospective study involving 86 women with endometriosis who had undergone IVF at our center between January 2015 till December 2017. The clinical pregnancy rate analyzed as the primary endpoint. Other outcomes measured include the total dose gonadotropin, the duration of stimulation, the number of oocytes retrieved, the number of MII oocytes, the number of grade 1 embryo, number of embryo transfer and frozen, fertilization and cancellation cycle rate.
RESULTS: Three groups were analyzed including stage II (N.=26), stage III (N.=27) and stage IV (N.=31). The clinical pregnancy rate higher in stage II compares to stage III and IV (69.2% vs. 37% vs. 38.7%). Surprisingly, they also had more follicles, oocytes retrieved and MII oocytes. The number of grade 1 embryo also significant seen in stage II compared to stage III and IV with p-value 0.006 (3.15±2.3 vs. 2±1.49 vs. 1.63±1.40). Women with stage III and IV endometriosis required a higher dose of endometriosis significantly (2781.94±835.57 and 2708.73±962.07) compared to stage II (2052.40±620.79). The duration of stimulation is almost similar in all stages of endometriosis. There was a similar result seen in the number of embryos transferred. A more frozen embryo is seen in stage II endometriosis significantly.
CONCLUSIONS: GnRH analogue integrated with COH protocol is recommended as a proper stimulation protocol for endometriosis especially in stage II endometriosis.

KEY WORDS: Endometriosis; Infertility; Gonadotropin-releasing hormone

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