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Does the type of GnRH analogue used, affect live birth rates in women with endometriosis undergoing IVF/ICSI treatment, according to the rAFS stage? / Drakopoulos, Panagiotis; Rosetti, Jérôme; Pluchino, Nicola; Blockeel, Christophe; Santos-Ribeiro, Samuel; de Brucker, Michael; Drakakis, Petros; Camus, Michel; Tournaye, Herman; Polyzos, Nikolaos P.

In: Gynecological Endocrinology, Vol. 34, No. 10, 03.10.2018, p. 884-889.

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@article{be5ef4095e4c4250a0a20e378786fe50,
title = "Does the type of GnRH analogue used, affect live birth rates in women with endometriosis undergoing IVF/ICSI treatment, according to the rAFS stage?",
abstract = "Since the introduction of gonadotropin-releasing hormone (GnRH) antagonists, an extensive amount of literature investigating the role of the downregulation protocols on pregnancy outcomes has been published. However, these studies were mainly performed in the general infertile population where patients with endometriosis were often excluded or underrepresented. This study is a large retrospective cohort study including 386 endometriosis patients undergoing IVF/ICSI, who had been previously classified according to the rAFS system. Patients were stimulated either a long GnRH agonist or GnRH antagonist protocol. Depending on endometriosis stage, patients were divided into two groups: endometriosis stage I-II and endometriosis stage III-IV. Each group was subdivided, based on the type GnRH analog used. When comparing the GnRH agonist and antagonist groups, patients with endometriosis stage I-II, had a tendency toward higher β-hCG positive, clinical pregnancy, and live birth rates (42.8{\%} vs. 26.7{\%}; p = .07) in favor of GnRH agonist use. In endometriosis stage III-IV, no differences were observed between agonist and antagonist cycle in any of the pregnancy outcomes. Multivariate regression analysis did not reveal any significant predictor of live birth after adjusting for relevant confounders. Based on our findings, the chance to have a liveborn in endometriosis population seems not to be affected by the type of GnRH analog used, at least in advanced stages. Findings from stage I-II endometriosis cases merit consideration and further evaluation in a larger sample size is warranted.",
keywords = "Endometriosis, GnRH agonist, GnRH antagonist, ovarian stimulation",
author = "Panagiotis Drakopoulos and J{\'e}r{\^o}me Rosetti and Nicola Pluchino and Christophe Blockeel and Samuel Santos-Ribeiro and {de Brucker}, Michael and Petros Drakakis and Michel Camus and Herman Tournaye and Polyzos, {Nikolaos P}",
year = "2018",
month = "10",
day = "3",
doi = "10.1080/09513590.2018.1460346",
language = "English",
volume = "34",
pages = "884--889",
journal = "Gynecological Endocrinology",
issn = "0951-3590",
publisher = "Informa Healthcare",
number = "10",

}

RIS

TY - JOUR

T1 - Does the type of GnRH analogue used, affect live birth rates in women with endometriosis undergoing IVF/ICSI treatment, according to the rAFS stage?

AU - Drakopoulos, Panagiotis

AU - Rosetti, Jérôme

AU - Pluchino, Nicola

AU - Blockeel, Christophe

AU - Santos-Ribeiro, Samuel

AU - de Brucker, Michael

AU - Drakakis, Petros

AU - Camus, Michel

AU - Tournaye, Herman

AU - Polyzos, Nikolaos P

PY - 2018/10/3

Y1 - 2018/10/3

N2 - Since the introduction of gonadotropin-releasing hormone (GnRH) antagonists, an extensive amount of literature investigating the role of the downregulation protocols on pregnancy outcomes has been published. However, these studies were mainly performed in the general infertile population where patients with endometriosis were often excluded or underrepresented. This study is a large retrospective cohort study including 386 endometriosis patients undergoing IVF/ICSI, who had been previously classified according to the rAFS system. Patients were stimulated either a long GnRH agonist or GnRH antagonist protocol. Depending on endometriosis stage, patients were divided into two groups: endometriosis stage I-II and endometriosis stage III-IV. Each group was subdivided, based on the type GnRH analog used. When comparing the GnRH agonist and antagonist groups, patients with endometriosis stage I-II, had a tendency toward higher β-hCG positive, clinical pregnancy, and live birth rates (42.8% vs. 26.7%; p = .07) in favor of GnRH agonist use. In endometriosis stage III-IV, no differences were observed between agonist and antagonist cycle in any of the pregnancy outcomes. Multivariate regression analysis did not reveal any significant predictor of live birth after adjusting for relevant confounders. Based on our findings, the chance to have a liveborn in endometriosis population seems not to be affected by the type of GnRH analog used, at least in advanced stages. Findings from stage I-II endometriosis cases merit consideration and further evaluation in a larger sample size is warranted.

AB - Since the introduction of gonadotropin-releasing hormone (GnRH) antagonists, an extensive amount of literature investigating the role of the downregulation protocols on pregnancy outcomes has been published. However, these studies were mainly performed in the general infertile population where patients with endometriosis were often excluded or underrepresented. This study is a large retrospective cohort study including 386 endometriosis patients undergoing IVF/ICSI, who had been previously classified according to the rAFS system. Patients were stimulated either a long GnRH agonist or GnRH antagonist protocol. Depending on endometriosis stage, patients were divided into two groups: endometriosis stage I-II and endometriosis stage III-IV. Each group was subdivided, based on the type GnRH analog used. When comparing the GnRH agonist and antagonist groups, patients with endometriosis stage I-II, had a tendency toward higher β-hCG positive, clinical pregnancy, and live birth rates (42.8% vs. 26.7%; p = .07) in favor of GnRH agonist use. In endometriosis stage III-IV, no differences were observed between agonist and antagonist cycle in any of the pregnancy outcomes. Multivariate regression analysis did not reveal any significant predictor of live birth after adjusting for relevant confounders. Based on our findings, the chance to have a liveborn in endometriosis population seems not to be affected by the type of GnRH analog used, at least in advanced stages. Findings from stage I-II endometriosis cases merit consideration and further evaluation in a larger sample size is warranted.

KW - Endometriosis

KW - GnRH agonist

KW - GnRH antagonist

KW - ovarian stimulation

UR - http://www.scopus.com/inward/record.url?scp=85045234888&partnerID=8YFLogxK

U2 - 10.1080/09513590.2018.1460346

DO - 10.1080/09513590.2018.1460346

M3 - Article

C2 - 29648476

VL - 34

SP - 884

EP - 889

JO - Gynecological Endocrinology

JF - Gynecological Endocrinology

SN - 0951-3590

IS - 10

ER -

ID: 38806783