| Autor: |
de Koning R; R de Koning, Leiden University Medical Center, Leiden, Netherlands., Cantineau AEP; A Cantineau, Obstetrics and Gynaecology, University Medical Centre Groningen, Groningen, Netherlands., van der Tuuk K; K van der Tuuk, Department of Obstetrics and Gynaecology, University Medical Centre Groningen, Groningen, Netherlands., De Bie B; B De Bie, Endometriosis Foundation of the Netherlands, Sittard, Netherlands., Groen H; H Groen, Epidemiology, University Medical Centre Groningen, Groningen, Netherlands., van den Akker-van Marle ME; M van den Akker-van Marle, Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, Netherlands., Nap AW; A Nap, Department of Obstetrics and Gynaecology, Radboudumc, Nijmegen, Netherlands., Maas JWM; J Maas, Department of Gynaecology and Grow-school of Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, Netherlands., Jansen FW; F Jansen, Department of Gynaecology, Leiden University Medical Centre, Leiden, Netherlands., Twijnstra ARH; A Twijnstra, Department of Gynaecology, Leiden University Medical Centre, Leiden, Netherlands., Blikkendaal MD; M Blikkendaal, Department of Gynaecology, Leiden University Medical Center, Leiden, 2300 RC, Netherlands. |
| Abstrakt: |
Currently, the optimal treatment to increase the chance of pregnancy and live birth in patients with colorectal endometriosis and subfertility is unknown. Evidence suggests that that both surgery and in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) are effective in improving live birth rate (LBR) among these women. However, the available evidence is of low quality, reports highly heterogeneous results, lacks direct comparison between both treatment options and does not assess whether a combination strategy results in a higher LBR compared to IVF/ICSI-only treatment. Additionally, the optimal timing of surgery within the treatment trajectory remains unclear. The primary objective of the TOSCA study is to assess the effectiveness of surgical treatment (potentially combined with IVF/ICSI) compared to IVF/ICSI-only treatment to increase the chance of an ongoing pregnancy resulting in a live birth in patients with colorectal endometriosis and subfertility, measured by cumulative LBR. Secondary objectives are to assess and compare quality of life and cost-effectiveness in both groups. Patients will be followed for 40 months after inclusion or until live birth. The TOSCA study is expected to be completed in 6 years. |
