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Randomized Controlled Trial
. 2021 Mar 30;21(1):264.
doi: 10.1186/s12884-021-03736-2.

Role of suppression of endometriosis with progestins before IVF-ET: a non-inferiority randomized controlled trial

Eissa Khalifa  1 , Hashem Mohammad  1 , Ameer Abdullah  1 , Mazen Abdel-Rasheed  2 , Mohammed Khairy  1 , Mahmoud Hosni  1
Affiliations
Randomized Controlled Trial

Role of suppression of endometriosis with progestins before IVF-ET: a non-inferiority randomized controlled trial

Eissa Khalifa et al. BMC Pregnancy Childbirth. .

Abstract

Background: Endometriosis affects the responsiveness to ovarian stimulation. This study aimed to assess the role of Dienogest pretreatment for endometriosis suppression as compared to Gonadotropin-releasing hormone agonist (GnRHa) in patients with endometriosis pursuing IVF treatment.

Methods: In this randomized controlled trial, 134 women with endometriosis-related infertility were randomly allocated to group A (n = 67) who had monthly depot GnRHa for 3 months before ovarian stimulation in IVF treatment (Ultra-long protocol), and Group B (n = 67) who had daily oral Dienogest 2 mg/d for 3 months before starting standard long protocol for IVF. The primary outcome measure was the number of oocytes retrieved. The secondary outcome measures included the number of mature oocytes, fertilization rate, quality of life assessed by FertiQoL scores, cost of treatment, and pregnancy outcomes.

Results: Although there was no statistically significant difference between both groups regarding ovarian stimulation, response parameters, and pregnancy outcomes, the Dienogest group had a lower cost of treatment (2773 vs. 3664 EGP, P < 0.001), lower side effects (29.9% vs. 59.7%, P < 0.001), higher FertiQoL treatment scores (33.2 vs. 25.1, P < 0.001) and higher tolerability scores (14.1 vs. 9.4, P < 0.001 < 0.001).

Conclusion: Our study indicates that Dienogest is a suitable and safe substitute for GnRHa pretreatment in endometriosis patients.

Trial registration: NCT04500743 "Retrospectively registered on August 5, 2020".

Keywords: Dienogest; Endometriosis; GnRH-analogue; IVF-ICSI; Progestins.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of ovarian stimulation in both groups
Fig. 2
Fig. 2
Flowchart of participants in the trial comparing GnRH agonist versus Dienogest pretreatment in endometriosis patients before ART
See this image and copyright information in PMC

References

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