Efficacy of guided ovarian hyperstimulation in patients with mild type endometriosis

Abstract

Background/Aim. Endometriosis befalls in one of the most frequent gynecologic diseases. It manifests itself by the presence and growth of focus of endometrium out of the uterus cavum that reacts to hormonal stimulations as the normal uterus endometrium does. Hyperstimulation and induction of ovulation together with intrauterine insemination (IUI) are the most frequently used treatments of unexplained infertility in patients with mild type endometriosis. The aim of this study was to compare the effects of stimulation using human menopausal gonadotrophine (hMG) in the patients with mild type endometriosis to the patients with infertility of unknown ethiology. Methods. The study included 50 patients with unexplained infertility (group N), as well as 50 patients with mild type endometriosis (group E) confirmed by laparoscopy. Within the same therapeutic protocole hMG stimulation and horionic gonadotrophine induction (hCG) were used. Results. In the group E ovulation occurred in 74% of the patients during the first stimulation, in 77.78% during the second cycle, and in 75% of the patients during the third one. Regarding the group N, ovulation appeared in 82% of the patients during the first stimulation. Stimulation was performed two times more in 38 patients with unknown couse of infertility, and ovulation appeared in 84.21% of them. In the group N stimulation was performed three times in 28 women resulting in ovulation in 85.71% of them. Conclusion. Considering the obtained results it can be concluded that hMG stimulation and hCG induction are efficient in the treatment of infertility, particularly in mild type endometriosis.Uvod/Cilj. Endometrioza je jedno od najcescih oboljenja u ginekologiji. Manifestuje se prisustvom i rastom zarista endometrijuma van kavuma uterusa koja reaguju na hormonsku stimulaciju kao normalni endometrijum uterusa. Hiperstimulacija i indukcija ovulacije zajedno sa intrauterusnom inseminacijom (IUI) najcesce se koriste u terapiji neobjasnjenog infertiliteta i kod bolesnica sa blagim oblikom endometrioze. Cilj rada bio je poredjenje efekata stimulacije humanim menopauznim gonadotropinima (hMG) kod bolesnica sa blagim oblikom endometrioze i kod bolesnica sa infertilitetom nepoznatog uzroka. Metode. Istrazivanjem smo obuhvatili 50 bolesnica sa neobjasnjenim infertilitetom (grupa N) i 50 sa blagim oblikom endometrioze (grupa E), koja je laparoskopski potvrdjena. Primenjena je stimulacija hMG i indukcija horionskim gonadotropinom (hCG) po istom terapijskom protokolu. Rezultati. U grupi E tokom prve stimulacije ovulacija se pojavila kod 74% bolesnica. U drugom ciklusu ovulacija se pojavila kod 77,78% bolesnica, a u trecem ciklusu u 75% slucajeva. U grupi N tokom prve stimulacije ovulacija se pojavila kod 82% bolesnica. Jos dva puta je primenjena stimulacija kod 38 bolesnica sa nepoznatim uzrokom infertiliteta. Ovulacija se pojavila u 84,21% slucajeva. Tri puta u grupi N primenjena je stimulacija kod 28 zena, pri cemu se kod 85,71% pojavila ovulacija. Zakljucak. Stimulacija hMG i indukcija hCG efikasni su nacini stimulacije i indukcije ovulacije u cilju lecenja infertiliteta, narocito u slucajevima blagog oblika endometrioze.