Efficacy of long-term pituitary down-regulation pretreatment prior to in vitro fertilization in infertile patients with endometriosis: A meta-analysis

Yizheng Tian; Lixia Zhang; Dan Qi; Lei Yan; Jialun Song; Yanbo Du

doi:10.1016/j.jogoh.2023.102541

Efficacy of long-term pituitary down-regulation pretreatment prior to in vitro fertilization in infertile patients with endometriosis: A meta-analysis

J Gynecol Obstet Hum Reprod. 2023 Mar;52(3):102541. doi: 10.1016/j.jogoh.2023.102541. Epub 2023 Jan 20.

Authors

Yizheng Tian¹, Lixia Zhang², Dan Qi¹, Lei Yan¹, Jialun Song³, Yanbo Du⁴

Affiliations

¹ Center for Reproductive Medicine, Shandong University, Jinan 250100, China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan 250100, China; Shandong Key Laboratory of Reproductive Medicine, Jinan 250012, China; Medical Integration and Practice Center, Shandong University, 44 Wenhuaxi Road, Jinan 250100, China; Gynecology Department, Reproductive Hospital Affiliated to Shandong University, Jinan 250001, China.
² Maternal and Child Health and Family Planning Service Center of Yanggu County, Liaocheng 252300, China.
³ Center for Reproductive Medicine, Shandong University, Jinan 250100, China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan 250100, China; Shandong Key Laboratory of Reproductive Medicine, Jinan 250012, China; Medical Integration and Practice Center, Shandong University, 44 Wenhuaxi Road, Jinan 250100, China; Gynecology Department, Reproductive Hospital Affiliated to Shandong University, Jinan 250001, China. Electronic address: songjialun@sduivf.com.
⁴ Center for Reproductive Medicine, Shandong University, Jinan 250100, China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan 250100, China; Shandong Key Laboratory of Reproductive Medicine, Jinan 250012, China; Medical Integration and Practice Center, Shandong University, 44 Wenhuaxi Road, Jinan 250100, China; Gynecology Department, Reproductive Hospital Affiliated to Shandong University, Jinan 250001, China. Electronic address: duyanbo@sduivf.com.

PMID: 36690299
DOI: 10.1016/j.jogoh.2023.102541

Abstract

Controversial conclusions have been made in previous studies regarding the influence of ultra-long gonadotropin-releasing hormone agonist (GnRH-a) in the reproductive outcomes of women with endometriosis who are undergoing in vitro fertilization/ intracytoplasmic sperm injection embryo transfer (IVF/ICSI-ET). An electronic search was conducted through PubMed, Embase, Cochrane Library, Web of Science, Elsevier ScienceDirect and Medline from inception until 10 September 2022. Only randomized studies were included. After the selection process, seven articles were eventually included in the meta-analysis. The pooling of the results showed the adverse effect of ultra-long protocol in terms of live birth rate (risk ratio (RR) = 0.53, 95% confidence intervals (CI): 0.31-0.9, P=0.02) and fertilization rate (RR = 1.18, 95% CI: 1.02-1.36, P=0.02). There was no statistical significance between the ultra-long protocol and long protocol of the rest outcome Indicators. The findings of this meta-analysis suggest that ultra-long GnRH-a does not appear to improve the results of IVF/ICSI treatment outcomes in patients with endometriosis.

Keywords: Clinical pregnancy rate; Endometriosis; Gonadotrophin-releasing hormone agonist; In vitro fertilization; Intracytoplasmic sperm injection; Pregnancy outcomes.

Publication types

Meta-Analysis
Review

MeSH terms

Down-Regulation
Endometriosis*
Female
Fertilization in Vitro / methods
Gonadotropin-Releasing Hormone
Humans
Infertility*
Male
Pregnancy
Pregnancy Rate
Semen

Substances

Gonadotropin-Releasing Hormone