Effect of GnRH agonist before IVF on outcomes in infertile endometriosis patients: a randomized controlled trial
| Autor: | Ana M. Monzo, Elisabet Rodríguez-Tárrega, Patrocinio Polo-Sánchez, Edurne Novella-Maestre, Pedro J. Fernández-Colom, Ramiro Quiroga, Mercedes Monterde-Estrada, Antonio Pellicer |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
0301 basic medicine endocrine system medicine.medical_specialty Pregnancy Rate Endometriosis Fertilization in Vitro Placebo law.invention Gonadotropin-Releasing Hormone 03 medical and health sciences Aromatase 0302 clinical medicine Randomized controlled trial Pregnancy law medicine Clinical endpoint Humans Single-Blind Method Testosterone Prospective Studies GnRH agonist Gynecology Triptorelin Pamoate 030219 obstetrics & reproductive medicine Estradiol CYP19A1 gene business.industry Androstenedione Obstetrics and Gynecology Arornatase medicine.disease Follicular fluid Follicular Fluid Clinical trial Luteolytic Agents 030104 developmental biology Reproductive Medicine IVF Female Live birth business Infertility Female Developmental Biology |
| Zdroj: | REPRODUCTIVE BIOMEDICINE r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe instname |
| ISSN: | 1472-6483 |
| DOI: | 10.1016/j.rbmo.2020.06.020 |
| Popis: | Research question: Does 3-months of gonadotrophin releasing hormone agonist (GnRHa) treatment before IVF improve clinical pregnancy rate in infertile patients with endometriosis? Design: Single-blind, placebo-controlled clinical trial of 200 infertile women with endometriosis assigned to use GnRHa (study group) or placebo (control group) for 3 months before IVF. Clinical, embryological outcomes and stimulation parameters were analysed. Clinical pregnancy rate was the primary endpoint. In a subgroup of 40 patients, follicular fluid levels of oestradiol, testosterone and androstendione were measured. Gene expression profile of CYP19A1 was analysed in cumulus and mural granulosa cells. Results: Implantation or clinical pregnancy rate were not significantly different between the two groups. Clinical pregnancy rates were 25.3% and 33.7% in the study and control groups, respectively (P = 0.212). Cumulative live birth rate was not significantly different: 22.0% (95% CI 13.0 to 31.0) in the study group and 33.7% (95% CI 24.0 to 44.0) in the control group (P = 0.077). Ovarian stimulation was significantly longer and total dose of gonadotrophins significantly higher in the study group (both P < 0.001). Serum oestradiol levels on the day of HCG were significantly lower in the study group (P = 0.001). Cancellation rate was significantly higher in the study group (P = 0.042), whereas cleavage embryos were significantly more numerous in the control group (P = 0.023). No significant differences in the expression of CYP19A1 gene in mural or cumulus granulosa cells or steroid levels in follicular fluid between the two groups were observed, but testosterone was significantly lower in the study group (P < 0.001). Conclusion: Three-months of GnRHa treatment before IVF does not improve clinical pregnancy rate in women with endometriosis. |
| Databáze: | OpenAIRE |
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