부산대학교 도서관

STUDY QUESTION: Does treatment with danazol for at least 4 months before IVF cycle improve the pregnancy rate in women with endometriosis? SUMMARY ANSWER: Danazol pre-treatment increases the pregnancy rate in women with endometriosis undergoing IVF WHAT IS KNOWN ALREADY: It is well known that danazol, an anti-estrogenic agent, may be useful in the treatment of endometriosis and the associated pelvic pain. Women with endometriosis show lower pregnancy when undergo IVF, since the reduced ovarian reserve as wellas the inflammatory processes of disease. It has been reported that danazol treatment may improve the IVF outcome. The aim of this study was to evaluate the effect of danazol pre-treatment in women with endometriosis undergoing IVF STUDY DESIGN, SIZE, DURATION: This randomized controlled trial was conducted on 60 women with endometriosis stage III/IV, diagnosed by laparoscopy undergoing IVF from October 2012 January 2013. Patients were randomized by a computer generated number sequence. All patients before allocation signed an informed consents form. PARTICIPANTS/MATERIALS, SETTING, METHODS: The sixty patients were divided in two groups of 30 women each, one group was treated with 400mg Danazol/day for at least 4 months before IVF cycle, whereas the other group was treated with placebo in the same way of the other group. Both group underwent the same ovarian hyperstimulation MAIN RESULTS AND THE ROLE OF CHANCE: Epidemiological data of the two group of patients were similar for womanʼs age, time of infertility, stage of diseases, number of previous surgery, ovarian reserve (FSH and AMH levels), and they were not statistically significant. Patients treated with danazol showed a higher pregnancy rate 50.0% (15/30) with respect to controls 20.0% (6/30) (P = 0.0292). Number of mature oocyte collected and number of tembryos obtained were similar in the two groups and were not statistically significant (3.5 ± 2.5 vs 3.4 ± 2.6 and 2.9 ± 1.1 vs 2.9 ± 1.2 respectively). LIMITATIONS, REASON FOR CAUTION: The number of patients included in the study is not large enough to obtain conclusive results, even though the data showed striking evidences that danazol in same cases may be useful. WIDER IMPLICATIONS OF THE FINDINGS: Our results showed that danazol pre-treatment may be useful in improving the IVF outcome in women with endometriosis. This may be due to the reduction of endometriosis activity determined by danazol, especially by decreasing the inflammatory process. Larger numberr of patients are needed to more conclusive results. STUDY FUNDING/COMPETING INTEREST(S): none TRIAL REGISTRATION NUMBER: NCT01779232