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Related Experiment Videos

Ovulation suppression for endometriosis.

E Hughes1, D Fedorkow, J Collins

  • 1Rm HSC-4F7, Department of Obstetrics and Gynaecology, McMaster University, 1200 Main St West, Hamilton, Ontario, Canada, L8N 3Z5. hughese@fhs.csu.mcmaster.ca

The Cochrane Database of Systematic Reviews
|May 5, 2000
PubMed
Summary
This summary is machine-generated.

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Ovulation suppression treatments for endometriosis-associated infertility show no significant benefit in clinical pregnancy rates compared to placebo or danazol. These therapies are not recommended due to lack of efficacy and potential adverse effects.

Area of Science:

  • Reproductive Endocrinology
  • Gynecologic Surgery
  • Infertility Research

Background:

  • Endometriosis etiology remains unknown, with retrograde menstruation as a leading theory.
  • Diagnosis requires laparoscopy, making incidence and prevalence data scarce.
  • The link between early-stage endometriosis and infertility is unclear.
  • Endometriosis is estrogen-dependent and often becomes quiescent after menopause.

Purpose of the Study:

  • To evaluate the effectiveness of ovulation suppression agents (danazol, medroxy progesterone acetate, gestrinone, oral contraceptives, GnRH analogues) versus placebo or no treatment for endometriosis-associated infertility.
  • To compare the efficacy of these agents against danazol in terms of clinical pregnancy rates.

Main Methods:

  • Systematic review of randomized controlled trials (RCTs) from the Cochrane Subfertility Review Group specialized register.

Related Experiment Videos

  • Inclusion of four RCTs with five treatment arms comparing ovulation suppression agents to placebo/no treatment.
  • Inclusion of eight trials comparing suppressive agents to danazol.
  • Data extraction and validity assessment by two independent reviewers.

    • Main Results:

    • Ovulation suppression versus placebo/no treatment yielded a common odds ratio for pregnancy of 0.83 (95% CI 0.5-1.39), indicating no significant benefit.
    • Comparison of all agents versus danazol showed a common odds ratio for pregnancy of 1.20 (95% CI 0.85-1.68), also suggesting no significant difference.
    • Statistical homogeneity was observed in both comparisons, despite clinical heterogeneity.

    Conclusions:

    • Ovulation suppression therapies demonstrate a lack of treatment benefit for endometriosis-associated infertility.
    • Significant amenorrhea and adverse effects associated with these treatments further support their non-recommendation.
    • Ovulation suppression is not advised as a standard therapy for infertility linked to endometriosis.