Ultralong administration of gonadotropin-releasing hormone agonists before in vitro fertilization improves fertilization rate but not clinical pregnancy rate in women with mild endometriosis: a prospective, randomized, controlled trial

Clinical pregnancy rates in women with mild endometriosis who received gonadotropin-releasing hormone agonists for 3 months after laparoscopy did not improve after in vitro fertilization and embryo transfer.

Volume 113, Issue 4, Pages 828–835


Apostolos Kaponis, M.D., Grigoris Chatzopoulos, M.D., Minas Paschopoulos, M.D., Ioannis Georgiou, Ph.D., Vaggelis Paraskevaidis, M.D., Konstantinos Zikopoulos, M.D., Konstantinos Tsiveriotis, M.D., Fuminori Taniguchi, M.D., Ph.D., D.M.Sci., George Adonakis, M.D., Tasuku Harada, M.D., Ph.D., D.M.Sci.



To evaluate the effects of gonadotropin-releasing hormone agonists (GnRH-a) on fertility in women with mild endometriosis who are undergoing in vitro fertilization and embryo transfer (IVF-ET) procedures.


Prospective, randomized, controlled trial.


Three tertiary university hospitals.


Four hundred infertile women with mild endometriosis, documented with laparoscopy, undergoing IVF and 200 women with tubal factor infertility.


Administration of GnRH-a for 3 months before an IVF attempt (group A, n = 200) or IVF without GnRH-a (group B, n = 200).

Main Outcome Measure(s)

Follicular fluid (FF) levels of tumor necrosis factor α (TNF-α), interleukin-1β (IL-1β), IL-6, IL-8, and IL-1 receptor antagonist; fertilization rate (FR), implantation rate (IR), quality of embryos, and clinical pregnancy rate (PR).


Women who received GnRH-a had a statistically significantly reduced concentration of FF cytokines compared with women who did not receive this regimen. Women in group B had a reduced FR (61.7; 95% CI, 59.20–64.20) compared with the women in group A (72.7; 95% CI, 70.50–74.90) and compared with the women with tubal factor infertility (74.7; 95% CI, 72.00–77.24). The embryo quality, IR, and clinical PR showed no statistically significant improvement in the women of group A compared with group B.


Women who received GnRH-a for 3 months had a lower concentration of FF cytokines. These women had also a higher FR than the women who did not receive GnRH-a. However, the IR, embryo quality, and clinical PR showed no statistically significant difference when comparing the two groups.

ClinicalTrials.gov ID


Read the full text here.