Ovarian suppression treatment prior to in-vitro fertilization and embryo transfer in Chinese women with stage III or IV endometriosis

Objective: To evaluate the efficacy of a 2-month treatment with a gonadotropin-releasing hormone (GnRH) agonist prior to in-vitro fertilization in Chinese women with moderate or severe endometriosis. Methods: A study of 162 women surgically diagnosed as having moderate or severe endometriosis. Pituitary down-regulation was achieved with injections of a GnRH agonist prior to the IVF procedures either for 7 to 10 days in the mid-luteal phase (group 1 [standard protocol], 97 cycles in total), or for 2 months (group 2, 55 cycles), or 3 months (group 3, 75 cycles). Results: Women pretreated with a GnRH agonist for 2 or 3 months required significantly higher doses of gonadotropin for ovarian stimulation (P < 0.001), and for a longer time, than those treated with the standard long protocol (P < 0.05). The number of oocytes and good embryos was lower in group 3 than in groups 1 or 2 (P < 0.05). The implantation rate was significantly higher in group 2 than in group 1 (P < 0.02). Conclusion: A 2-month treatment with a GnRH agonist prior to IVF produced a trend toward an increase in the implantation rate in a group of Chinese women with stages III and IV endometriosis. (c) 2007 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.