Better Birth Rate With GnRH
The Cochrane Library has published an update that shows a much higher live birth rate for women with endometriosis who take gonadotrophin releasing hormone (GnRH) agonist for from 3-6 months prior to attempting in vitro fertilization (IVF). The significant increase in live births was seen only in the group that received this treatment. A second, control group who did not receive the GnRH agonist treatment had a much poorer rate for live births. In addition to these findings, the study also showed that the number of pregnancies was also much higher in the women treated with GnRH agonists prior to fertilization attempts.
The gynecological condition known as endometriosis is manifested by the growth of uterine tissue outside of the uterus. The disease causes severe menstrual pain and affects a woman's chances for conceiving a child.
Women with endometriosis have a much lower success rate for pregnancy after undergoing IVF or intra cytoplasmic sperm injection (ICSI), two generally successful fertility treatments, when compared to women who have fertility issues due to abnormalities of their fallopian tube. It seems that endometriosis has the ability to influence the way that eggs develop and that the disease interferes with the ability of the ovaries to manufacture eggs that are capable of fertilization. But treatment with GnRH agonists appears to lessen the effects of endometriosis, so that the ovaries can perform their job during procedures like IVF and ICSI.
While performing a systematic review of the available literature on the topic of endometriosis and fertilization techniques, scientists discovered that treatment with GnRH agonists in women with endometriosis 3-6 months prior to IVF and ICSI gave those women a fourfold edge in successful conception over women who didn't receive the GnRH agonist treatment in advance of the procedures. "The chances of having a live birth are also increased, though currently the data is not strong enough to show how great that increase is," says lead author of the study, Professor Hassan Sallam, from the department of Obstetrics and Gynaecology at Alexandria University, in Egypt. "At the moment there is no data showing whether the treatment leads to better eggs or better acceptance of embryos by the lining of the womb," says Sallam.
There is also no data that shows the superiority of the GnRH agonist over other agonists. No research has been done to show whether the treatment produces different results depending on the severity of the endometriosis disease process in individual women.