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

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.