The Effects of Long-Term Dienogest Therapy on In Vitro Fertilization Outcomes in Women with Endometriosis: A Systematic Review and Meta-Analysis.
J Obstet Gynaecol Can
; 46(4): 102339, 2024 Apr.
Article
en En
| MEDLINE
| ID: mdl-38176680
ABSTRACT
OBJECTIVES:
Assessing dienogest's efficacy in endometriosis patients undergoing in vitro fertilization (IVF). DATA SOURCES Systematic search in databases (PubMed, MEDLINE, Embase, Web of Science, Cochrane CENTRAL, Google Scholar) until 1 October 2022. STUDY SELECTIONS Randomized trials and observational studies comparing extended dienogest pre-treatment, no pre-treatment, or gonadotropin-releasing hormone (GnRH) agonist pre-treatment in endometriosis-linked IVF. OUTCOMEMEASURES:
live birth, clinical pregnancy rates, oocytes collected, miscarriage rate, gonadotropin consumption. DATA EXTRACTIONS AND SYNTHESES Two authors independently assessed eligibility. Dichotomous variables were analyzed via a random-effect model and Mantel-Haenszel method to calculate weighted estimates and 95% confidence intervals (CI). I2 statistic gauged study heterogeneity; GRADE criteria evaluated evidence quality.CONCLUSIONS:
Out of 191 publications, five studies with 723 participants were included. Uncertainty persists on whether prolonged dienogest affects live birth (RR 1.42, 95% CI 0.29 to 6.84; 3 studies, n = 289; I2 86%) and clinical pregnancy rates (RR 1.33, 95% CI 0.31 to 5.65; 3 studies, n = 289; I2 86%) compared to conventional IVF. Moreover, uncertainty remains regarding intervention impact on live birth (RR 1.46, 95% CI 0.63 to 3.37; 1 study, n = 34) and clinical pregnancy rates (RR 1.32, 95% CI 0.78 to 2.23; 3 studies, n = 288; I2 0%) versus long-term GnRH agonist therapy before IVF. Given limited data and very low evidence quality, doubts arise about the benefits of long-term dienogest pre-treatment before conventional IVF in endometriosis patients.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Fertilización In Vitro
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Endometriosis
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Nandrolona
Tipo de estudio:
Clinical_trials
/
Observational_studies
/
Prognostic_studies
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Systematic_reviews
Límite:
Female
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Humans
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Pregnancy
Idioma:
En
Revista:
J Obstet Gynaecol Can
Asunto de la revista:
GINECOLOGIA
/
OBSTETRICIA
Año:
2024
Tipo del documento:
Article
País de afiliación:
Canadá