New treatment strategy for endometriosis using progestin-primed ovarian stimulation with dienogest: A prospective cohort study, comparison of dienogest versus dydrogesterone

Iwami, Nanako; Kawamata, Miho; Ozawa, Naoko; Yamamoto, Takahiro; Watanabe, Eri; Mizuuchi, Masahito; Moriwaka, Osamu; Kamiya, Hirobumi

doi:10.1016/j.repbio.2020.100470

Cited by 12 publications

(25 citation statements)

References 43 publications

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“…One article [4] was excluded for not having a control group (in that study, the control group was given leuprorelin acetate, 3.75 mg monthly for 3 months). The other four articles [21][22][23][24] -one randomized controlled trial and three cohort studies -were included in the meta-analysis (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

“…In three studies [22][23][24], which included 160 patients from DNG group and 188 patients from the control group, the investigators reported the number of mature oocytes. We found no significant difference among those studies (mean difference = -1.27, 95% CI: -3.63 to 1.09, I 2 = 91%; Fig.…”

Section: Resultsmentioning

confidence: 99%

“…In the prospective cohort study by Iwami et al's. [24], 73 patients who presented with severe dysmenorrhea or were at high risk for endometriosis recurrence after previous surgery took 2 mg of DNG daily before assisted reproduction treatment. Thus, the endometriosis…”

Section: Discussionmentioning

confidence: 99%

“…In addition, to address apparent heterogeneity (I 2 > 50%), we used a random-effects model, but subgroup analysis was unfeasible: we could not compare patients who had undergone surgery for endometriosis with those who had not. This is because Barra et al [23] excluded patients with a history of surgery for endometriosis, Muller et al [21] and Tamura et al [22] included only patients who underwent surgery for endometriosis, and Iwami et al Gynecol Obstet Invest 2023;88:135-142 DOI: 10.1159/000529400 [24] did not mention the number of patients who underwent surgery and of those who did not. Our study may have had selection bias because patients who received DNG presented with severe dysmenorrhea or were at high risk for endometriosis recurrence after previous surgery in the study by Iwami et al [24].…”

Section: Color Version Available Onlinementioning

confidence: 99%

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Pretreatment of Dienogest for Women with Endometriosis in in vitro Fertilization: A Systematic Review and Meta-Analysis

Lin

Zhang

et al. 2023

Gynecol Obstet Invest

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Introduction Dienogest (DNG) was demonstrated to be comparable to gonadotropin-releasing hormone agonist (GnRH-a) in controlling symptoms of endometriosis. GnRH-a is used before in vitro fertilization (IVF) in women with endometriosis to improve pregnancy outcomes. We aimed to determine the effect of DNG pretreatment on IVF outcomes, including number of mature oocytes, rate of clinical pregnancies, and rate of live births in women with endometriosis. Methods All studies involving DNG, IVF and endometriosis were searched from the PubMed, Ovid/MEDLINE, Wanfang, CQVIP, China National Knowledge Infrastructure databases and ClinicalTrials.gov. The study population was women with endometriosis in IVF. Randomized controlled trials and cohort studies were included. All included studies comprised a DNG group and a control group. The outcomes were number of mature oocytes, rate of clinical pregnancies and rate of live births. We calculated the odds ratio or mean difference, and 95% confidence interval for each study, and used a random-effects model to estimate the results. Results Five articles were screened by the search strategy. One article without a control group was excluded. Finally, four articles with 422 patients were included. No significant differences in number of mature oocytes (MD=-1.27, 95% CI=-3.63-1.09, I²=91%), the rate of clinical pregnancies (odds ratio = 1.07, 95% CI = 0.33–3.47, I² = 84%) or the rate of live births (odds ratio =1.13, 95% CI=0.37‐3.45, I²=83%) were found between the DNG group and the control group. Conclusion Pretreatment with DNG for women with endometriosis who underwent IVF could not improve the number of mature oocytes, the rate of clinical pregnancies or the rate of live births.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Color Version Available Onlinementioning

confidence: 99%

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Pretreatment of Dienogest for Women with Endometriosis in in vitro Fertilization: A Systematic Review and Meta-Analysis

Lin

Zhang

et al. 2023

Gynecol Obstet Invest

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“…It has been reported that the clinical and ongoing pregnancy rates in PPOS with dydrogesterone are comparable to those of a GnRH antagonist protocol 7 . One recent study reported that the rate of mature oocytes was higher with PPOS using dienogest (DNG) than with DYG, although the fertilization rate was similar 8 . In contrast, there are very few reports on PPOS with chlormadinone acetate (CMA), an oral progestin.…”

Section: Introductionmentioning

confidence: 99%

Chlormadinone acetate in progestin‐primed ovarian stimulation does not negatively affect clinical results

Shibasaki,

Hattori,

Koizumi

et al. 2023

Reprod Medicine & Biology

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PurposeTo investigate whether progestin‐primed ovarian stimulation (PPOS) with chlormadinone acetate (CMA) adversely affects clinical results and neonatal outcomes, or causes congenital deformities.MethodsThis retrospective study was conducted at private IVF clinic from November 2018 to November 2021. Women underwent oocyte retrieval using gonadotropin‐releasing hormone (GnRH) antagonist protocol (n = 835) or PPOS protocol (n = 57) were included. Eligible patients were normal ovarian responders (aged <40, AMH ≧1.0 ng/mL) with freeze‐all cycle. Embryo developments, clinical results, or neonatal outcomes of singletons derived from transfer of frozen single blastocysts were compared within each group.ResultsPatient characteristics were similar in both groups. The median LH level (mIU/mL) at trigger in the GnRH antagonist group [2.0 (1.2–3.7)] was significantly higher than in the PPOS group [0.9 (0.3–1.7)]. There was no cycle with premature LH surge in the PPOS group. Fertilization and blastocyst formation rates did not differ significantly between groups. Furthermore, clinical outcomes were also similar in the two groups. Congenital abnormality rates did not differ significantly [0.9% (3/329), 0.0% (0/17)].ConclusionsCMA using ovarian stimulation did not negatively affect clinical results. Our data suggest that PPOS with CMA is an appropriate ovarian stimulation method for normal ovarian responders.

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Hormonal Therapy in Endometriosis and Adenomyosis: Progestins

Darıcı

Oral

2022

Endometriosis and Adenomyosis

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New treatment strategy for endometriosis using progestin-primed ovarian stimulation with dienogest: A prospective cohort study, comparison of dienogest versus dydrogesterone

Cited by 12 publications

References 43 publications

Pretreatment of Dienogest for Women with Endometriosis in in vitro Fertilization: A Systematic Review and Meta-Analysis

Pretreatment of Dienogest for Women with Endometriosis in in vitro Fertilization: A Systematic Review and Meta-Analysis

Chlormadinone acetate in progestin‐primed ovarian stimulation does not negatively affect clinical results

Hormonal Therapy in Endometriosis and Adenomyosis: Progestins

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