Background: Administration of GnRH agonist on endometriosis can increased apoptosis and inhibit proliferation of endometrial cells ectopic. How the effectiveness of GnRH agonist for 3-6months prior to FIV in endometriosis needs to be studied further. Objective: To determine the effectiveness of GnRH agonists for 3-6 months before FIV output number of mature oocytes, total dose and duration of gonadotropin stimulation with a long protocol stimulation.
Methods: This study uses a retrospective observational cohort design. Total population in this study were 60patientsfrom Klinik Permata Hati DrRSSardjitofrom2003 to2011.
Results: Total of60 subjecsof60couples undergoingin vitro fertilizationwere includedin the studyaccording toinclusion and exclusioncriteria.Ovarian stimulation long after stimulation suppression therapy ≥ 10 days of 10 subjecs (33.3%), length of stimulation <10 days of 20 subjecs (66.7%), whereas those without suppression therapy, the stimulation of long ≥ 10 days and 7 subjecs (23, 3%) and longer stimulation of <10 days of 23 subjecs (76.7%). Number of total gonadotropin dose (≥ 40 pack) during stimulation without suppressive therapy in group 3 subjecs (10%) and after 5 subjecs of therapy (16.6% ). Fifty-six subjecs (93.3%) with a high number of oocytes (≥ 3 oocytes) and 4 subjecs (6.7%) by the number of oocytes is low (<3 oocytes). Minimal-mild endometriosis stage (I-II) 27 subjecs (45%), moderate-severe stage (III-IV) 33 subjecs (55%). Group after ovarian suppression therapy prior to clinical FIV give 1.07 times the chance of increasing the number of oocytes than in those withoutsuppression therapy.
Conclusion: The number of mature oocytes and the number of total gonadotropin dose was higher in the post-suppression therapy compared with no therapy. Long ovarian stimulation is more elongated in the post-treatment group compared with no therapy.
Keywords: Controlled ovarian stimulation response, oocyte number, ovarian stimulation, long protocol, in vitro fertilization, endometriosis, ovarian suppression, GnRH agonist.