Endometriosis management prior to IVF

Endometriosis affects up to 10% of reproductive-aged women; with higher prevalence among patients suffering from dysmenorrhea, infertility and chronic pelvic pain (CPP). Early detection is the basis of targeting at time therapy. Administration of GnRH-agonists (GnRHa) is limited with its safety and portability. Dienogest administration as the stage of preparation to in vitro fertilization (IVF) may provide the preparative pre-gravid reserve. Fifty-six infertile patients with adenomyosis and previous IVF failures were recruited for prospective cohort study. The treatment followed the unique algorithm created using clinical experience. Post-transfer support was also considered. The aims included evaluation of dienogest effectiveness for different stages of adenomyosis; working out the schemes of dienogest therapy prior to IVF; evaluation of IVF effectiveness after dienogest administration. Patients with adenomyosis grade I-II demonstrated encouraging results: normalisation of menstrual function in 68.6% cases; decreasing of CPP in 74.3% of patients; better uterine vascularisation in 48.6% cases; IVF effectiveness increased up to 48.6%. Thus, in cases of adenomyosis and previous IVF failures dienogest should be administrated prior to IVF, which results in higher IVF effectiveness. © 2015 © 2015 Taylor & Francis.