The effect of endometriosis in pelvis is bypassed by means of assisted reproductive technologies but affecting ovary and uterus may decrease the quality of ovocyte. This anomaly and changes of endometrium regarding morphology and function and the effects on ovocyte can be amended by OCP and GnRH agonist. There are some controversies between various studies regarding Down Regulation Protocols before IVF and their influences on the results.
Studies show that treatment of endometriosis by GnRH agonist 3 to 6 months before ART can improve the outcome and they also show that endometriosis treatment with oral contraceptives has similar results with fewer side effects. In the present study, in order to study above mentioned findings, we have analyzed and compared the effects of GnRH Agonist and OCP before IVF on pregnancy results of patients with endometriosis III and IV grade in Arash Infertility Clinic in 1392-93.
Method:
In this comparative study, 70 women with endometriosis III and IV grade were randomly divided into two groups. The first group was treated with two dosages of GnRH agonist in a 4-week interval. The first dose was used in 21th of the cycle and COH was performed 7-10 days after the second dose. The second group was treated with LD for 6-8 continuous weeks. After 2 months, LD consumption was stopped and COH was performed in the second or third day of the cycle.
Findings:
Fertilization rate, implantation rate and pregnancy rate were higher in the OCP group but there was no significant difference between two groups. This study shows that a 6week treatment with OCP before ART in patients with endometriosis not only improves the results but also is as influential as GnRH agonist treatment 3-6 month before ART. |