Recurrent endometrioma in infertile patients has worse outcome than primary endometrioma in response to controlled ovarian hyperstimulation and intrauterine insemination
Journal of Reproductive Medicine, cilt.64, sa.4, ss.282-290, 2019 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 64 Sayı: 4
- Basım Tarihi: 2019
- Dergi Adı: Journal of Reproductive Medicine
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.282-290
- Anahtar Kelimeler: adenomyosis, artificial insemination, assisted reproductive techniques, deep infiltrative endometriosis, endometrioma, endometriosis, infertility, intrauterine insemination, ovulation induction, pelvic pain/diagnosis
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
OBJECTIVE: To investigate the difference in the effectiveness of controlled ovarian hyperstimulation and intrauterine insemination (COH+IUI) on pregnancy rates in patients with pri-mary and recurrent endometriomas. STUDY DESIGN: Multi-center, retrospective cohort study done in 3 tertiary referral centers. Included in the study were (1) primary infertility patients with endometriomas who had no other probable cause for infertility, (2) those who underwent 2 cycles of COH+IUI, provided the sperm test was nor-mal, (3) those who had at least 1 patent fallopian tube, and (4) those whose ovarian reserve was normal with ovulatory cycles. Therapy for COH was hMG (meno-tropin) or recombinant follicle-stimulating hormone (follitropin alfa, beta) at 75 IU/d starting from day 3. Trigger was done by 5,000–10,000 human chorionic gonadotropin or choriogonadotropin alfa 250 µg/0.5 mL when the dominant follicle size reached 18 mm. RESULTS: The ongoing pregnancy rates in patients with primary endometrioma were 14.4% per patient and 8.06% per cycle. In patients with recurrent endometrio-ma, the ongoing pregnancy rates were 6.06% per patient and 3.4% per cycle. Ongoing pregnancy rates were significantly higher in patients with primary endometrioma than in recurrent endometrioma patients. CONCLUSION: COH+IUI may be recommended even before surgery for couples with primary endometriomas when there is no other infertility factor. COH+IUI treatment is not recommended for recurrent endometrioma patients.