Pre-operative endometrial thinning agents before endometrial destruction for heavy menstrual bleeding

A randomised controlled trial comparing GnRH antagonist Cetrorelix with GnRH agonist Leuprorelin for endometrial thinning prior to transcervical resection of endometrium

“…Endometrial thickness (single layer) seen in our study appears to correlate well with other studies where only one dose of GnRH agonist was used 2,17 . Endometrial results obtained with cetrorelix pre‐treatment, however, does appear to be better than placebo pre‐treated women in postmenstrual phase seen in other studies, although ideally a placebo arm in our study would have confirmed this.…”

“…Endometrial thickness (single layer) seen in our study appears to correlate well with other studies where only one dose of GnRH agonist was used. 2,17 Endometrial results obtained with cetrorelix pre-treatment, however, does appear to be better than placebo pre-treated women in postmenstrual phase seen in other studies, although ideally a placebo arm in our study would have confirmed this. The mean single-layer endometrial thickness following cetrorelix pre-treatment seen in our study (2.50 mm) is thinner than that measured during the postmenstrual phase reported by Donnez et al (3.53 mm for placebo group as compared with 1.61 mm for goserelin treated).…”

“…16 There is now good evidence to show that pre-thinning the endometrium enables even experienced surgeons easier, faster surgery with higher amenorrhoea rates 6 months after surgery compared with those who had the procedure performed in the postmenstrual phase after receiving placebo injections. 2,17 Our pilot study, although limited in not being controlled, confirmed that a single 3 mg dose of cetrorelix could reliably induce a withdrawal bleeding within 2-3 days, irrespective of the phase of menstrual cycle. Therefore, the same dosage was used in the main study.…”

A randomised controlled trial comparing GnRH antagonist Cetrorelix with GnRH agonist Leuprorelin for endometrial thinning prior to transcervical resection of endometrium

“…Endometrial thickness (single layer) seen in our study appears to correlate well with other studies where only one dose of GnRH agonist was used 2,17 . Endometrial results obtained with cetrorelix pre‐treatment, however, does appear to be better than placebo pre‐treated women in postmenstrual phase seen in other studies, although ideally a placebo arm in our study would have confirmed this.…”

“…Endometrial thickness (single layer) seen in our study appears to correlate well with other studies where only one dose of GnRH agonist was used. 2,17 Endometrial results obtained with cetrorelix pre-treatment, however, does appear to be better than placebo pre-treated women in postmenstrual phase seen in other studies, although ideally a placebo arm in our study would have confirmed this. The mean single-layer endometrial thickness following cetrorelix pre-treatment seen in our study (2.50 mm) is thinner than that measured during the postmenstrual phase reported by Donnez et al (3.53 mm for placebo group as compared with 1.61 mm for goserelin treated).…”

“…16 There is now good evidence to show that pre-thinning the endometrium enables even experienced surgeons easier, faster surgery with higher amenorrhoea rates 6 months after surgery compared with those who had the procedure performed in the postmenstrual phase after receiving placebo injections. 2,17 Our pilot study, although limited in not being controlled, confirmed that a single 3 mg dose of cetrorelix could reliably induce a withdrawal bleeding within 2-3 days, irrespective of the phase of menstrual cycle. Therefore, the same dosage was used in the main study.…”

Postpartum transcervical endometrial resection under laparoscopic control for retained degenerated products of conception

“…An injection of Zoladex 3.6 mg subcutaneous was given to the patient, as it has been suggested that Zoladex induces endometrial thinning, reducing operating time and improving the intrauterine operating environment during endometrial ablation [5]. In our study it softened the texture of the retained trophoblastic tissue.…”

Indications and options for endometrial ablation

“…Down-regulation with a GnRH agonist is effective when used for 30 to 60 days before the ablative procedure. Similar results have been demonstrated with preoperative danazol treatment (600 mg-800 mg daily for 15-30 days) (3). Few data from randomized trials are available to assess the effectiveness of various progestogens (e.g., oral contraceptives, medroxyprogesterone acetate, and norethindrone acetate) as endometrial thinning agents (3).…”

A randomised controlled trial comparing GnRH antagonist Cetrorelix with GnRH agonist Leuprorelin for endometrial thinning prior to transcervical resection of endometrium

“…Endometrial thickness (single layer) seen in our study appears to correlate well with other studies where only one dose of GnRH agonist was used 2,17 . Endometrial results obtained with cetrorelix pre‐treatment, however, does appear to be better than placebo pre‐treated women in postmenstrual phase seen in other studies, although ideally a placebo arm in our study would have confirmed this.…”

“…Endometrial thickness (single layer) seen in our study appears to correlate well with other studies where only one dose of GnRH agonist was used. 2,17 Endometrial results obtained with cetrorelix pre-treatment, however, does appear to be better than placebo pre-treated women in postmenstrual phase seen in other studies, although ideally a placebo arm in our study would have confirmed this. The mean single-layer endometrial thickness following cetrorelix pre-treatment seen in our study (2.50 mm) is thinner than that measured during the postmenstrual phase reported by Donnez et al (3.53 mm for placebo group as compared with 1.61 mm for goserelin treated).…”

“…16 There is now good evidence to show that pre-thinning the endometrium enables even experienced surgeons easier, faster surgery with higher amenorrhoea rates 6 months after surgery compared with those who had the procedure performed in the postmenstrual phase after receiving placebo injections. 2,17 Our pilot study, although limited in not being controlled, confirmed that a single 3 mg dose of cetrorelix could reliably induce a withdrawal bleeding within 2-3 days, irrespective of the phase of menstrual cycle. Therefore, the same dosage was used in the main study.…”

Postpartum transcervical endometrial resection under laparoscopic control for retained degenerated products of conception

“…An injection of Zoladex 3.6 mg subcutaneous was given to the patient, as it has been suggested that Zoladex induces endometrial thinning, reducing operating time and improving the intrauterine operating environment during endometrial ablation [5]. In our study it softened the texture of the retained trophoblastic tissue.…”

Indications and options for endometrial ablation

“…Down-regulation with a GnRH agonist is effective when used for 30 to 60 days before the ablative procedure. Similar results have been demonstrated with preoperative danazol treatment (600 mg-800 mg daily for 15-30 days) (3). Few data from randomized trials are available to assess the effectiveness of various progestogens (e.g., oral contraceptives, medroxyprogesterone acetate, and norethindrone acetate) as endometrial thinning agents (3).…”

A randomised controlled trial comparing GnRH antagonist Cetrorelix with GnRH agonist Leuprorelin for endometrial thinning prior to transcervical resection of endometrium

“…Endometrial thickness (single layer) seen in our study appears to correlate well with other studies where only one dose of GnRH agonist was used 2,17 . Endometrial results obtained with cetrorelix pre‐treatment, however, does appear to be better than placebo pre‐treated women in postmenstrual phase seen in other studies, although ideally a placebo arm in our study would have confirmed this.…”

“…Endometrial thickness (single layer) seen in our study appears to correlate well with other studies where only one dose of GnRH agonist was used. 2,17 Endometrial results obtained with cetrorelix pre-treatment, however, does appear to be better than placebo pre-treated women in postmenstrual phase seen in other studies, although ideally a placebo arm in our study would have confirmed this. The mean single-layer endometrial thickness following cetrorelix pre-treatment seen in our study (2.50 mm) is thinner than that measured during the postmenstrual phase reported by Donnez et al (3.53 mm for placebo group as compared with 1.61 mm for goserelin treated).…”

“…16 There is now good evidence to show that pre-thinning the endometrium enables even experienced surgeons easier, faster surgery with higher amenorrhoea rates 6 months after surgery compared with those who had the procedure performed in the postmenstrual phase after receiving placebo injections. 2,17 Our pilot study, although limited in not being controlled, confirmed that a single 3 mg dose of cetrorelix could reliably induce a withdrawal bleeding within 2-3 days, irrespective of the phase of menstrual cycle. Therefore, the same dosage was used in the main study.…”

Postpartum transcervical endometrial resection under laparoscopic control for retained degenerated products of conception

“…An injection of Zoladex 3.6 mg subcutaneous was given to the patient, as it has been suggested that Zoladex induces endometrial thinning, reducing operating time and improving the intrauterine operating environment during endometrial ablation [5]. In our study it softened the texture of the retained trophoblastic tissue.…”

Indications and options for endometrial ablation

“…Down-regulation with a GnRH agonist is effective when used for 30 to 60 days before the ablative procedure. Similar results have been demonstrated with preoperative danazol treatment (600 mg-800 mg daily for 15-30 days) (3). Few data from randomized trials are available to assess the effectiveness of various progestogens (e.g., oral contraceptives, medroxyprogesterone acetate, and norethindrone acetate) as endometrial thinning agents (3).…”