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Effect of Long GnRH-agonist Hormonal Suppression on IVF-ET Treatment in Stage-III (moderate) or Stage-IV (severe) Grades of Endometriosis-Associated Infertility.

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Title Effect of Long GnRH-agonist Hormonal Suppression on IVF-ET Treatment in Stage-III (moderate) or Stage-IV (severe) Grades of Endometriosis-Associated Infertility.
 
Creator Chakravarty, B N
Goswami, S K
Kabir, S N
 
Subject Cell Biology & Physiology
 
Description Objective: To evaluate the efficacy of prolonged gonadotropin-releasing
hormone-agonist (GnRH-a) hormonal suppression on IVF-ET outcome in
the patients with moderate/severe grades of endometriosis (AFS grades III
& IV). A retrospective analysis was done on 117 cycles of 54 patients
undergoing IVF-ET treatment for endometriosis-associated infertility.
Materials/Methods: Diagnosis and staging of endometriosis were confirmed
by laparoscope only in 33 women, while laparoscope was followed
by laparotomy in 21 cases. The patients were randomly distributed into 2
group-I (n � 25) received GnRH-a hormonal suppression for a
period of 6 months followed by IVF-ET. Patients failing to achieve pregnancy
in the first cycle were subjected to IVF-ET in subsequent cycles,
maximum for 3 cycles (total 53 cycles), using conventional protocol of
controlled ovarian hyperstimulation. The remaining 29 patients (group-II)
had conventional ‘long’ protocol GnRH-a down regulation. In this group,
like in group-I, IVF-ET was performed maximum for 3 cycles (total 64
cycles). Treatment outcome was assessed in terms of ovarian response, rates
of clinical pregnancy/cycle, cumulative pregnancy and pregnancy wastage.
The prolonged GnRH-a suppressed group resulted in significantly
(p � 0.01) increased the rates of oocyte retrieval (7.9 � 1.5) and
transferable embryos per cycle (3.9 � 1.3) in comparison to those of the
conventionally stimulated group (oocytes: 4.9 � 1.5; transferable embryo:
2.8 � 0.8). The pregnancy rate per cycle was statistically comparable
between the groups (group-I: 15% vs. group-II: 9%), but in group-I, cumulative
pregnancy rate after 3 cycles was significantly (p � 0.05) higher
(group-I: 52% vs. group-II: 27%) and rate of miscarriage was lower
(group-I: 12% vs. group-II: 33%).
In moderate and severe grades of endometriosis-associated
infertility, prolonged GnRH-a hormonal suppression is an effective regime
for improving cumulative pregnancy and take home baby rates following
IVF-ET.
 
Date 2002
 
Type Article
PeerReviewed
 
Format application/pdf
 
Identifier http://www.eprints.iicb.res.in/795/1/FERTILITY_AND_STERILITY__77(_2_)__(Supplement_1)_S13%2DS13;2002[70].pdf
Chakravarty, B N and Goswami, S K and Kabir, S N (2002) Effect of Long GnRH-agonist Hormonal Suppression on IVF-ET Treatment in Stage-III (moderate) or Stage-IV (severe) Grades of Endometriosis-Associated Infertility. Fertility and Sterility , 77 (Supp.2). S13-S13.
 
Relation http://dx.doi.org/10.1016/S0015-0282(01)03046-1
http://www.eprints.iicb.res.in/795/