Ruiz-Velasco V, Allende S
Center for the Study of Fertility, Santa Monica Hospital, Mexico City, Mexico.
Int J Fertil Womens Med. 1998 Jan-Feb;43(1):18-23.
Demonstrate the usefulness of combined treatment of a Gn-RH agonist and assisted reproduction in the management of infertile women with endometriosis.
A prospective evaluation of goserelin's action (Gn-RH(a)) in the extension of endometriosis, of its suppression and clinical improvement, and in pregnancy rates after an immediate assisted reproduction program. SITE: Infertility clinic at a private hospital related to other university hospitals.
18 infertile patients with laparoscopically-confirmed endometriosis.
All women were submitted to general laboratory tests, FSH, LH and estradiol measurements, and laparoscopy before and after treatment. All were treated for 6 months with goserelin and, when menstruating, the patients were submitted to an assisted reproduction program with a scheme of HMG + FSH + HCG.
Improvement of endometriosis and achievement of pregnancy.
An improvement of the endometriosis score was confirmed in 100% of the cases. The average pretreatment score of 44.8 points decreased to 18.3 after treatment. Similarly, the pain reported by eight of the patients practically disappeared after using the Gn-RH analogue. During treatment with goserelin, all women had amenorrhea. Their periods resumed in an average of 80.5 days after the last injection. In three (17.6%) cases, no follicular response was obtained, and stimulation was suspended. The remaining responses were good: eight GIFT procedures, four IVF-ET procedures and two IUIs resulted in eight pregnancies (57.1%), one of which terminated in an abortion (the patient became pregnant again). The eight pregnancies had good results: one was double and another quadruple. Most importantly, all pregnancies were achieved during the first treatment attempt.
Combined treatment of goserelin with immediate assisted reproduction is a satisfactory procedure, which achieves a high percentage of pregnancies at the first try and with few abortions in cases of infertile women with endometriosis.
证明促性腺激素释放激素（Gn-RH）激动剂与辅助生殖联合治疗在子宫内膜异位症不孕女性管理中的有效性。
对戈舍瑞林（Gn-RH(a)）在子宫内膜异位症扩展、抑制及临床改善方面的作用，以及在即刻辅助生殖计划后的妊娠率进行前瞻性评估。地点：与其他大学医院相关的一家私立医院的不孕诊所。
18例经腹腔镜确诊为子宫内膜异位症的不孕患者。
所有女性在治疗前后均接受常规实验室检查、促卵泡生成素（FSH）、促黄体生成素（LH）及雌二醇测量，以及腹腔镜检查。所有患者均接受戈舍瑞林治疗6个月，月经来潮时，患者接受人绝经期促性腺激素（HMG）+促卵泡素（FSH）+人绒毛膜促性腺激素（HCG）方案的辅助生殖计划。
子宫内膜异位症的改善及妊娠的实现。
100%的病例子宫内膜异位症评分得到改善。治疗前平均评分为44.8分，治疗后降至18.3分。同样，8例患者报告的疼痛在使用Gn-RH类似物后几乎消失。在戈舍瑞林治疗期间，所有女性均闭经。最后一次注射后平均80.5天月经恢复。3例（17.6%）未获得卵泡反应，刺激中止。其余反应良好：8例配子输卵管内移植（GIFT）手术、4例体外受精-胚胎移植（IVF-ET）手术和2例宫腔内人工授精（IUI）导致8例妊娠（57.1%），其中1例以流产告终（该患者再次怀孕）。8例妊娠结果良好：1例为双胎，另1例为四胎。最重要的是，所有妊娠均在首次治疗尝试时实现。
戈舍瑞林与即刻辅助生殖联合治疗是一种令人满意的方法，对于子宫内膜异位症不孕女性，首次尝试时妊娠率高且流产少。
