EFFICIENCY OF COMBINED TREATMENT OF INFERTILITY ASSOCIATED WITH ENDOMETRIOSIS


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Abstract

A prospective, randomized trial to evaluate the effectiveness of combined treatment of endometriosis-associated infertility with the use of gonadotropin releasing hormone agonist (GRHA), gestagen (dienogest), and combined oral contraceptives in 100 patients was performed. It is shown that combined treatment of infertility in patients with endometriosis with the use of surgical method (coagulation and excision of foci of endometriosis) followed by the administration of GRHA or dienogest is effective for a third part of patients and does not differ depending on the variant of drug therapy. However, patients who received GRHA were 2 times more likely to have a nondeveloping pregnancy. The efficacy of both approaches to the treatment of endometriosis was high in both groups, but the frequency and severity of side effects were more significant in patients receiving GRHA.

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About the authors

N. V Artymuk

Kemerovo State Medical University

Email: artymuk@gmail.com
MD, Prof., Head of the Department of Obstetrics and Gynecology № 2, Chief Freelance Specialist of the Russian Ministry of Health in Obstetrics and Gynecology in the Siberian Federal District, President of the Kemerovo Regional Public Organization «Association of Obstetricians and Gynecologists» Kemerovo

L. N Danilova

Kemerovo Regional Clinical Perinatal Center n.a. Prof. L.A. Reshetova

Kemerovo

V. O Chervov

Kemerovo State Medical University

Kemerovo

S. V Rybnikov

Kemerovo Regional Clinical Perinatal Center n.a. Prof. L.A. Reshetova

Kemerovo

O. A Tachkova

Kemerovo State Medical University

Kemerovo

References

  1. Эндометриоз, диагностика, лечение и реабилитация. Клинические рекомендации по ведению больных / Под ред. Л.В. Адамян. М., 2013.
  2. Park S.Y., Kim S.H., Chae H.D., Kim C.H., Kang B.M. Efficacy and safety of dienogest in patients with endometriosis: A single-center observational study over 12 months. Clin. Exp. Reprod. Med. 2016;43(4):215-220.
  3. Middleton L.J., Daniels J.P., Weckesser A., Bhattacharya S. Preventing recurrence of endometriosis by means of long-acting progestogen therapy (PRE-EMPT): report of an internal pilot, multi-arm, randomised controlled trial incorporating flexible entry design and adaption of design based on feasibility of recruitment; PRE-EMPT trial collaborative group. Trials. 2017;18(1):121.
  4. Артымук Н.В., Данилова Л.Н., Червов В.О., Рыбников С.В., Тачкова О.А., Черняева В.И. Комбинированное лечение пациенток с эндометриозом и бесплодием с применением агонистов гонадотропин-рилизинг гормона и диеногеста. Проблемы репродукции. 2016;22(5):93-7.
  5. Rudnicki M., Gemzell-Danielsson K., Gidlöf S. When endometriosis is the barrier for fertility. Acta Obstet Gynecol Scand. 2017;96(6):621-22.
  6. Артымук Н.В., Тачкова О.А., Данилова Л.Н. Современные возможности медикаментозного контроля эндометриоза. Доктор РУ. 2015;11(112):39-44.
  7. Mishra V.V., Bandwal P., Agarwal R., Aggarwal R. Prevalence, Clinical and Laparoscopic Features of Endometriosis Among Infertile Women. J Obstet Gynaecol India. 2017;67(3):208-12.
  8. Kim S.A., Um M.J., Kim H.K., Kim S.J., Moon S.J., Jung H. Study of dienogest for dysmenorrhea and pelvic pain associated with endometriosis. Obstet. Gynecol. Sci. 2016;59(6):506-11.
  9. Alkatout I., Mettler L., Beteta C., Hedderich J., Jonat W., Schollmeyer T., et al. Combined surgical and hormone therapy for endometriosis is the most effective treatment: prospective, randomized, controlled trial. J. Minim Invasive Gynecol. 2013;20:473-81.
  10. Becker C.M., Gattrell W.T., Gude K., Singh S.S. Reevaluating response and failure of medical treatment of endometriosis: a systematic review. Fertil Steril. 2017;108(1):125-36.
  11. Leone Roberti Maggiore U., Ferrero S., Salvatore S. Urinary incontinence and bladder endometriosis: conservative management. Int. Urogynecol. J. 2014 Sep 3. http://dx.Doi. org/10.1007/s00192-014-2487-6.
  12. Donnez J. Endometriosis and risk of embryonic aneuploidy? Fertil Steril. 2017. pii: S0015-0282(17)30472-7.
  13. Sanchez A.M., Vanni V.S., Bartiromo L., Papaleo E., Zilberberg E., Candiani M., Orvieto R., Viganò R Is the oocyte quality affected by endometriosis? A review of the literature. J. Ovarian Res. 2017;10:43. Published online 2017 Jul 12.
  14. Zheng Q., Mao H., Xu Y., Zhao J., Wei X., Liu P Can postoperative GnRH agonist treatment prevent endometriosis recurrence? A meta-analysis. Arch. Gynecol. Obstet. 2016;294(1):201-7.
  15. Sugimoto K., Nagata C., Hayashi H., Yanagida S., Okamoto A. Use of dienogest over 53 weeks for the treatment of endometriosis. J. Obstet. Gynaecol. Res. 2015;41(12):1921-26.
  16. Petraglia F., Hornung D., Seitz C., Faustmann T., Gerlinger C., Luisi S., et al. Reduced pelvic pain in women with endometriosis: efficacy of long-term dienogest treatment. Arch. Gynecol. Obstet. 2012;285:167-173.

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