Dienogest Versus GnRH-a Pre-treatment in Women With Endometriosis Undergoing IVF

Launched by AMERICAN UNIVERSITY OF BEIRUT MEDICAL CENTER · May 3, 2017

Keywords

ClinConnect Summary

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Gender

FEMALE

Eligibility criteria

• Inclusion Criteria:
• • Primary or secondary infertility
• • Endometriosis, stage III - IV, confirmed surgically by laparoscopy or laparotomy and/or radiologically by the presence of endometrioma on pelvic ultrasound or magnetic resonance imaging (MRI)
• • Normal uterine cavity assessed by hysteroscopy or hysterosalpingogram
• • Normal hormonal profile: TSH, prolactin, fasting blood sugar
• • Normal semen analysis and mild/moderate male factor (Total motile sperm count \> 5 million/ml and/or normal WHO morphology \>20%)
• • First IVF cycle or history of failed IVF cycles
• • Washout period of ≥6 months after any diagnostic or therapeutic surgery for endometriosis or after any medical treatment with Dienogest or GnRH agonist.
• Exclusion Criteria:
• • • Low ovarian reserve defined by one of the following: low AMH ≤1.5ng/mL and/or basal day 3 FSH ≥ 10mIU/mL and/or basal day 3 Estradiol ≥ 60ng/mL and/or previous egg collection yield of ≤3 oocytes.
• • Absolute contraindications to dienogest, including:
• • undiagnosed abnormal vaginal bleeding
• • pregnancy and/or lactation
• • active venous thromboembolic disorder
• • history of or current arterial and cardiovascular disease (eg, MI, CVA)
• • diabetes mellitus with vascular involvement
• • history of or current severe hepatic disease where liver function tests remain abnormal
• • history of or current hepatic neoplasia (benign or malignant)
• • known or suspected sex-hormone-dependent malignancy
• • ocular lesions due to ophthalmic vascular disease, such as partial or complete vision loss or defect in visual fields
• • current or history of migraine with focal aura
• • hypersensitivity or poor tolerance to dienogest