The clinical outcome of Dienogest treatment followed by in vitro fertilization and embryo transfer in infertile women with endometriosis

Endometriosis is considered to be the most intractable cause of female infertility. Administering any type of treatment for endometriosis before in vitro fertilization and embryo transfer (IVF-ET) is an important strategy for improving the IVF-ET outcomes for infertile women with endometriosis. In f...

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Published in:	Journal of ovarian research Vol. 12; no. 1; p. 123
Main Authors:	Tamura, Hiroshi, Yoshida, Hiroaki, Kikuchi, Hiroyuki, Josaki, Mai, Mihara, Yumiko, Shirafuta, Yuichro, Shinagawa, Masahiro, Tamura, Isao, Taketani, Toshiaki, Takasaki, Akihisa, Sugino, Norihiro
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 12-12-2019 BioMed Central BMC
Subjects:	Abortion Adult Agonists Antioxidants Antioxidants (Nutrients) Blastocysts Care and treatment Clinical outcomes Cytokines Cytokines - immunology Dienogest Embryo Embryo Transfer Embryonic development Embryos Endometriosis Endometriosis - drug therapy Endometriosis - immunology Endometrium Female Female infertility Fertilization in Vitro Fluids Follicles Follicular Fluid - immunology Gonadotropin-releasing hormone Gonadotropin-Releasing Hormone - antagonists & inhibitors Gonadotropins Growing follicle Hormone Antagonists - therapeutic use Hormones Humans Implantation In vitro fertilization Infertile Infertility Infertility, Female - drug therapy Infertility, Female - immunology Inflammation IVF-ET Laparoscopy Medicine Nandrolone - analogs & derivatives Nandrolone - therapeutic use Oocytes Oral administration Oxidative Stress Patient outcomes Pharmaceutical industry Pharmaceuticals Pituitary (anterior) Pituitary hormones Pregnancy Progestin Retirement benefits Sperm Treatment Outcome Tumor necrosis factor-TNF Ultrasonic imaging Women Japan United States > US Endometriosis Infertile IVF-ET Dienogest Growing follicle
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Summary:	Endometriosis is considered to be the most intractable cause of female infertility. Administering any type of treatment for endometriosis before in vitro fertilization and embryo transfer (IVF-ET) is an important strategy for improving the IVF-ET outcomes for infertile women with endometriosis. In fact, treatment with a gonadotropin-releasing hormone (GnRH) agonist just before IVF-ET has been reported to improve the clinical outcome in endometriosis patients. However, the benefit of Dienogest (DNG), a synthetic progestin, treatment just before IVF-ET remains unclear. Sixty-eight infertile women with Stage III or IV endometriosis (ovarian endometrial cyst < 4 cm) were recruited for this study. The subjects were divided into 2 groups: a DNG group (n = 33) and a control group (n = 35). DNG was administered orally every day for 12 weeks prior to the conventional IVF-ET cycle in the DNG group. Standard controlled ovarian hyperstimulation with the GnRH agonist long protocol was performed in the control group. The numbers of mature follicles and retrieved oocytes, fertilization rates, implantation rates, and clinical pregnancy rate were compared between the two groups. In addition, the concentrations of inflammatory cytokines, oxidative stress markers, and antioxidants in follicular fluids were also measured. The numbers of growing follicles, retrieved oocytes, fertilized oocytes, and blastocysts were significantly lower in the DNG group than in the control group. The fertilization and blastocyst rates were also lower in the DNG group than in the control group. Although there was no significant difference in the implantation rate between the groups, the cumulative pregnancy rate and live birth rate were lower in the DNG group than in the control group. There was no significant difference in the abortion rate. Our results failed to show that DNG reduces the inflammatory cytokine levels and oxidative stress in follicular fluids. Administering DNG treatment just before IVF-ET did not provide any benefits to improve the clinical outcomes for infertile women with endometriosis.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-News-1 ObjectType-Feature-3 content type line 23
ISSN:	1757-2215 1757-2215
DOI:	10.1186/s13048-019-0597-y