Authors
Fedele L. Parazzini F. Radici E. Bocciolone L. Bianchi S. Bianchi C. Battista Candiani G.
Institution
Istituto 'Mario Negri', Via Eritrea, 62,20157 Milan; Italy.
Title:
Buserelin acetate versus expectant management in the treatment of infertility associated with minimal or mild endometriosis: A randomized clinical trial (1992-1036).
Source:
American Journal of Obstetrics and Gynecology. Vol 166(5) (pp345-1350), 1992.
Abstract:
Objectives:
We performed a randomized clinical trial to evaluate the efficacy of intranasal 400 mug buserelin three times daily for 6 months versus expectant management in the treatment of infertile women with pelvic endometriosis stage I or II of the revised American Fertility Society classification.
Study Design:
Seventy-one consecutive patients (mean age 32 years) were studied at the First Department of Obestetrics and Gynecology, University of Milan, and the Department of Obstetrics and Gynecology, Ospedali Riuniti, Bergamo, between February 1988 and June 1989. Thirty-five women were randomly allocated to buserelin treatment and 36 to expectant management. The baseline distribution of subjects for age, disease stage and reproductive history was similar in the two groups. All patients were followed regularly; median follow-up was 17 months in the buserelin group and 18 months in the women given expectant management. If pregnancy did not occur within 12 months of randomization, cycles were monitored by ultrasonography and hormone measurements, and when abnormalities were detected clomiphene citrate and human chorionic gonadotropin were administered.
Results:
A total of 17 pregnancies were observed both in the buserelin-treated patients and in the expectant management group. The 1- and 2-year actuTimes New Roman overall pregnancy rates were similar in the two groups, 30% and 61% in the former and 37% and 61% in the latter group, respectively. Spontaneous abortion occurred in five of the 17 pregnancies in the women treated with buserelin and in one of the 17 in those managed expectantly; this difference was, however, not statistically significant (chi12 adjusted for disease stage and use of clomiphene citrate and human chorionic gonadotropin treatment = 3.01, p = 0.08). No fetal death or stillbirth was observed.
Conclusions:
Our findings suggest that treatment with gonadotropin-releasing hormone agonists is unlikely to have a marked influence on the reproductive outcome of infertile women with minimal or mild endometriosis.
Please click on the required question.
- 1 What is infertility?
- 2 How prevalent are infertility problems?
- 3 What are the main causes of infertility?
- 4 What are the objectives of our infertility investigations?
- 5 Have there been any noticeable changes in fertility requirements in recent years?
- 6 What is the effect of our age on fertility?
- 7 I smoke cigarettes. Can this have an effect on my fertility?
- 8 Does my weight influence fertility?
- 8A Obesity! How can I lose weight?
- 9 I have fibroids. Could these reduce my fertility?
- 10 I have been told that my womb has an abnormal shape and that was the way that I was born. Could this reduce my fertility?
- 11 I have endometriosis. Could this reduce my fertility?
- 12 I have been told that I have cervicitis or a cervical ectopy (erosion). Could this impair my fertility?
- 13 My doctor tells me that my womb is retroverted (tilts backwards). Could this reduce my fertility?
- 14 I have had an ectopic pregnancy. Does this affect my future fertility?
- 15 We are worried that we may have a fertility problem. What should we do?
- 16 How will our doctor be able to identify the cause of our infertility?
- 17 How can we tell if I am releasing my eggs (ovulating)?
- 18 Investigations have shown that I have a problem releasing my eggs (anovulation). What could be the cause of this?
- 19 How important are my Fallopian tubes in fertility?
- 20 How can we tell if my Fallopian tubes are functioning?
- 21a What are the causes of male factor infertility?
- 21 How can we assess male fertility?
- 22 What is the purpose of a post-coital test (PCT)?
- 23 We have had our infertility investigations and our problem remains unexplained. How can this be?
- 24 What are our chances of achieving a pregnancy?
- 25 Where can I obtain more information?
- 26 Could we have some recommended infertility support groups?
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