Endometriosis and IVF: are agonists really better? Analysis of 1180 cycles with the propensity score matching

Rodriguez-Purata, J.; Coroleu, Buenaventura; Tur, Rosa; Carrasco, Beatriz; Rodríguez, I.; Nolasco, Boaventura

doi:10.3109/09513590.2013.808327

Cited by 36 publications

(35 citation statements)

References 17 publications

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“…GnRH agonist treatment can force endometriosis into long term remission [219,220]. However, this is at the expense of infertility and other side-effects reminiscent of menopause such as hot flashes, vaginal dryness, and bone loss [211,221]. These side-effects can be minimized by co-administration of a low-dose estrogen or progestin hormone replacement therapy (HRT).…”

Section: Introductionmentioning

confidence: 99%

Molecular aspects of development and regulation of endometriosis

Aznaurova

Жуматаев

Roberts

et al. 2014

Reprod Biol Endocrinol

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Endometriosis is a common and painful condition affecting women of reproductive age. While the underlying pathophysiology is still largely unknown, much advancement has been made in understanding the progression of the disease. In recent years, a great deal of research has focused on non-invasive diagnostic tools, such as biomarkers, as well as identification of potential therapeutic targets. In this article, we will review the etiology and cellular mechanisms associated with endometriosis as well as the current diagnostic tools and therapies. We will then discuss the more recent genomic and proteomic studies and how these data may guide development of novel diagnostics and therapeutics. The current diagnostic tools are invasive and current therapies primarily treat the symptoms of endometriosis. Optimally, the advancement of “-omic” data will facilitate the development of non-invasive diagnostic biomarkers as well as therapeutics that target the pathophysiology of the disease and halt, or even reverse, progression. However, the amount of data generated by these types of studies is vast and bioinformatics analysis, such as we present here, will be critical to identification of appropriate targets for further study.

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Section: Introductionmentioning

confidence: 99%

Molecular aspects of development and regulation of endometriosis

Aznaurova

Жуматаев

Roberts

et al. 2014

Reprod Biol Endocrinol

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“…However, this analysis was limited only to 3 studies without specifically examining those with intact endometrioma(s). There is currently no solid evidence to support a routine use of a particular OS protocol, despite few studies that have revealed similar pregnancy outcomes either with agonists or antagonists (31,32). In our study, both OS protocols yielded comparable OPR and LBRs in END group without any significant difference.…”

Section: Discussionmentioning

confidence: 41%

The Impact of Ovarian Endometrioma(s) on ART Outcomes: Retrospective Case Control Study

Pabuçcu

Gürsoy

Ulubaşoğlu

et al. 2016

Gynecol Obstet Reprod Med

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OBJECTIVE:To compare oocyte yield of women with intact ovarian endometrioma(s) to those without endometrioma undergoing ART. Secondary outcomes were implantation and live birth rates between the two groups. STUDY DESIGN:Retrospective case-control study was conducted to document eligible cases. A total of 165 women with intact endometrioma(s) (END) were included in the final analysis. Total of 196 cases with tubal factor infertility who underwent ART in the same time period were included as controls (CONT group). Cases and controls were matched for age, BMI and serum AMH concentrations. Ovarian stimulation characteristics and pregnancy outcomes including live birth data were documented for both groups. RESULTS:Despite similar demographic characteristics, significantly longer cycle duration and higher amounts of gonadotropin consumption was observed in END group compared to controls (p<0.001). Significantly lower number of retrieved oocytes, mature oocytes and mature oocyte fraction (%, no of retrieved/mature) were detected in END group. There was no statistically significant difference in terms of fertilization, implantation and live birth rate per started cycle among groups. Cycle cancellations were also similar. CONCLUSION:In women with intact ovarian endometrioma(s) undergoing ART, oocyte quantity, especially mature oocyte yield was hampered. However, adequate number of mature oocytes, successful fertilization and satisfactory implantation rates might be possible contributing to acceptable live births. Further randomized controlled trials of patients with different sizes of endometrioma(s) would be needed to confirm our conclusions.

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“…Purata et al compared the efficacy of ANT protocols with that of AG in a large series including those with stage I-IV endometrioma without indicating endometrioma cases. 22 The study by Pabuccu et al is the only randomized controlled trial (RCT) comparing different OS protocols in cases with intact endometrioma regardless of size information. 19 Despite the higher number of oocytes (6.7 in ANT vs 8.2 in AG) that were retrieved with AG, both protocols yielded similar fertilization (73.5 vs 75.6) and CP (20.5 vs 24.2%) rates.…”

Section: Discussionmentioning

confidence: 99%

Long Agonist or Short Antagonist Protocol in Women with Intact Endometrioma(s) Undergoing ICSI: Retrospective Analysis

Pabuçcu¹,

Ulubaşoğlu²,

Şahin³

et al. 2018

TJRMS

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Is to evaluate the efficacy of different ovarian stimulation (OS) protocols in patients with intact endometrioma(s) undergoing ICSI. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Retrospective chart review was performed. A total of 717 women were detected to have endometriosis of which 165 women with intact endometrioma(s) were included in the final analysis. A total of 60 women were detected in long agonist (AG) and 105 in short antagonist protocol (ANT). Subgroup analysis was performed to document OS outcomes of poor responders fulfilling the Bologna criteria. R Re es su ul lt ts s: : Significantly shorter cycle duration and lower gonadotropin consumption was observed with ANT protocol compared to AG (p<0.001). The OS outcomes in terms of implantation, ongoing pregnancy (OP) and live birth rate per started cycle (LBR) were comparable in both groups. Overall LBR was 22,4%. Both protocols revealed similar but poor reproductive outcomes in terms of ongoing pregnancy (11.1%) and live birth rates (7.4%) in poor responders. C Co on nc cl lu us si io on n: : AG or ANT protocols seemed to be equally effective in terms of oocyte yield and LBRs in women with intact endometrioma undergoing OS. Shorter duration and lower gonadotropin consumption may be attributed to the convenience of ANT protocol. In poor responders, reproductive outcomes are still not satisfactory with either protocol K Ke ey yw wo or rd ds s: : Agonist protocol; antagonist protocol; endometriomas Ö ÖZ ZE ET T A Am ma aç ç: : ICSI uygulanan intakt endometrioma hastalarında farklı ovaryan stimülasyon protokollerinin etkinliğini değerlendirmektir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Çalışma Retrospektif olarak yapıldı. Endometriosisi olan toplam 717 kadın çalışmaya dahil edildi. Bunlardan intak endometrioması olan 165 kadın nihayi analize dahil edildi. Uzun agonist protokol 60 kadına ve short antagonist protokolde toplam 105 kadına uygulandı. Alt grup analizi, Bologna kriterlerini yerine getiren poor responderlerin ovulasyon stimulasyon sonuçlarını dökümente etmek için gerçekleştirildi. B Bu ul lg gu ul la ar r: : Antagonist protokolde agoniste göre anlamlı derecede daha kısa siklus süresi ve düşük gonadotropin tüketimi gözlendi (p<0,001). Her iki grupta da, implantasyon, devam eden gebelik ve siklus başına canlı doğum oranı açısından ovulasyon stimulasyon sonuçları benzerdi. Canlı doğum oranı %22,4 idi. Her iki protokolde benzer sonuçlar ortaya çikardı.Ama poor responderlarda devam eden gebelik (%11,1), canlı doğum oranları (%7,4) açısından zayıf üreme sonuçları ortaya çıkmıştır. S So on nu uç ç: : Agonist veya antagonist protokolleri, intak endometrioma olan kadınlarda oosit eldesi ve canlı doğum oranı açısından eşit derecede etkili görünmektedir. Kısa siklus süre ve daha düşük gonadotropin tüketimi, antagonist protokolünün kolaylığıdır. Poor responderlarda üreme sonuçları, her iki protokolde de tatmin edici değildir.

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Endometriosis and IVF: are agonists really better? Analysis of 1180 cycles with the propensity score matching

Abstract: After matching patients by PS, PR after COH with either GnRHa or GnRHant may be equally effective.

Cited by 36 publications

References 17 publications

Molecular aspects of development and regulation of endometriosis

Molecular aspects of development and regulation of endometriosis

The Impact of Ovarian Endometrioma(s) on ART Outcomes: Retrospective Case Control Study

Long Agonist or Short Antagonist Protocol in Women with Intact Endometrioma(s) Undergoing ICSI: Retrospective Analysis

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