Maged Ahmed Mohamed, Rashwan Hamsa, Mahmoud Maryam, El-Mazny Akmal, Farouk Mona, Belal Doaa S, Marie Heba M
1 Department of Obstetrics & Gynecology, Cairo University, Egypt.
Reprod Sci. 2018 Oct;25(10):1509-1514. doi: 10.1177/1933719118756753. Epub 2018 Feb 13.
To evaluate the effect of prolonged Gonadotropin releasing hormone (GnRH) agonist downregulation in patients with endometriomas of less than 5 cm on the outcome of the proceeding Intracytoplasmic sperm injection (ICSI) trial.
In a randomized controlled trial at a university teaching hospital, 90 patients indicated for ICSI and having unilateral single endometrioma of less than 5 cm in diameter were randomized into 2 groups. Group A (45 patients) received the standard long protocol; whereas group B (45 patients) received 3 consecutive Intramuscular (IM) injections of triptorelin 3.75 mg 28 days apart followed by the standard long protocol 28 days after the last injection.
There were no significant differences in the clinical and hormonal characteristics between the 2 groups. All ICSI cycle characteristics including number of retrieved oocytes, fertilized oocytes, and transferred embryos were also not significantly different. However, patients who received prolonged GnRH agonist therapy showed significantly higher chemical ( P = .011), clinical ( P = .018), and ongoing ( P = .028) pregnancy rates.
Prolonged GnRH agonist downregulation improves the pregnancy rates in patients with small endometriomas undergoing ICSI.
评估对直径小于5cm的子宫内膜异位囊肿患者延长促性腺激素释放激素（GnRH）激动剂降调节对后续卵胞浆内单精子注射（ICSI）试验结果的影响。
在一所大学教学医院进行的一项随机对照试验中，90例拟行ICSI且单侧单个直径小于5cm子宫内膜异位囊肿的患者被随机分为2组。A组（45例患者）接受标准长方案；而B组（45例患者）在28天的间隔内连续3次肌内注射3.75mg曲普瑞林，在最后一次注射后28天再接受标准长方案。
两组间临床和激素特征无显著差异。所有ICSI周期特征，包括获卵数、受精卵数和移植胚胎数也无显著差异。然而，接受延长GnRH激动剂治疗的患者化学妊娠率（P = 0.011）、临床妊娠率（P = 0.018）和持续妊娠率（P = 0.028）显著更高。
延长GnRH激动剂降调节可提高接受ICSI的小子宫内膜异位囊肿患者的妊娠率。
