Pre-IVF GnRH agonists boost pregnancy rates for endometriosis patients

February 2006

A Cochrane review has found that endometriosis patients who use gonadotropin-releasing hormone (GnRH) agonists in the run-up to IVF have improved outcomes.

In a systematic review of the existing literature, reviewers, led by Professor Hassan Sallam, from Alexandria University in Egypt, found that giving GnRH agonists to women with endometriosis for 3-6 months before fertility treatment increased their chances of becoming pregnant more than four-fold.

“The chances of having a live birth are also increased, though currently the data are not strong enough to show how great that increase is,” said Sallam.

Overall, the chances of pregnancy are lower for fertility patients who have endometriosis than for those who have problems with their fallopian tubes.

It has been thought that endometriosis may impair egg development and prevent the ovaries producing viable eggs, but Sallam says there are currently no data to show whether the treatment leads to better eggs or whether it facilitates implantation.

In addition, there are no results to show whether one particular agonist is superior to the others, or whether the effects of therapy differ in women with mild or severe endometrial disease, the reviewers explain.

Source

Sallam HN, Garcia-Velasco JA, Dias S, Arici A. Long-term pituitary down-regulation before in vitro fertilization (IVF) for women with endometriosis. Cochrane Database of Systematic Reviews 2006; 1.