Increased pregnancy rates after ultralong postoperative therapy with gonadotropin-releasing hormone analogs in patients with endometriosis.

ABSTRACT

OBJECTIVE: To examine whether ultralong GnRH analog (GnRH-a) therapy after surgical treatment of endometriosis and before ART influences the pregnancy rate. DESIGN: Prospective, randomized, controlled study. SETTING: University clinic for reproductive medicine and gynecologic endocrinology. PATIENT(S) One hundred ten patients with stage II to IV endometriosis according to ASRM criteria. INTERVENTION(S) Fifty-five patients received GnRH-a for 6 months after surgery and subsequently underwent up to 3 cycles of ART, and 55 patients received 3 cycles of ART alone immediately after surgery. MAIN OUTCOME MEASURE(S) Clinical pregnancy rates. RESULTS: The pregnancy rate per patient was higher among patients who received follow-up treatment with GnRH-a. The same results were found in patients with stage III or IV endometriosis who were undergoing IUI or IVF/ICSI. CONCLUSION(S) Ultralong GnRH-a therapy increases the pregnancy rate of ART in patients with severe endometriosis.