Treatment of Infertile Adenomyosis Patients Using Levonorgestrel-releasing Intrauterine System or Gonadotropin-releasing Hormone Agonist Before Frozen Blastocyst Transfer Improves Manifestations and Increases the Chances of Pregnancy
Overview
- Phase
- Not Applicable
- Intervention
- levonorgestrel-releasing intrauterine system
- Conditions
- Adenomyosis
- Sponsor
- Zagazig University
- Enrollment
- 184
- Locations
- 1
- Primary Endpoint
- Adenomyosis Treatment
- Status
- Completed
- Last Updated
- last year
Overview
Brief Summary
Adenomyosis is a condition where endometrial tissue grows into the uterine muscle, causing symptoms like pelvic pain, heavy bleeding, and infertility. This abnormal growth can lead to a variety of reproductive issues, including a higher risk of miscarriage and early pregnancy loss.
While there are treatments available for adenomyosis, they are often limited due to the lack of precise diagnostic criteria. One common approach is the use of gonadotropin-releasing hormone agonist (GnRHa), which can improve pregnancy rates in infertile women with adenomyosis. However, it's important to note that GnRHa may not restore pregnancy rates to baseline levels.
Another potential treatment option is the levonorgestrel-releasing intrauterine system (LNG-IUS). This device releases a hormone called levonorgestrel into the uterus, which can help control the symptoms of endometriosis and adenomyosis. Studies have shown that the endometrial concentration of levonorgestrel from the LNG-IUS is significantly higher than in other tissues like the myometrium, fallopian tubes, and fat tissue.
Investigators
Walid Mohamed Elnagar
Assistant professor of Obstetrics & Gynecology
Zagazig University
Eligibility Criteria
Inclusion Criteria
- •Women who have adenomyosis diagnostic characteristics and underwent ICSI that resulted in good-quality FE.
Exclusion Criteria
- •Women Women who have adenomyosis diagnostic characteristics and underwent ICSI that resulted in Poor-quality FE.
Arms & Interventions
The levonorgestrel-releasing intrauterine system Group
Intervention: levonorgestrel-releasing intrauterine system
The levonorgestrel-releasing intrauterine system Group
Intervention: frozen embryo transfer
GnRHa Group
Intervention: Triptorelin
GnRHa Group
Intervention: frozen embryo transfer
Outcomes
Primary Outcomes
Adenomyosis Treatment
Time Frame: 6 monthes
Proportion of patients reporting at least a 50% reduction in pain (measured by pain, Enjoyment, and General Activities score) post-Adenomyosis Treatment.
Increase in Chemical and Clinical Pregnancy Rates
Time Frame: 6 Months
Proportion of patients reported with pregnancy after Frozen Embryo transfer which is assessed by finding Heartbeats in the Trans-vaginal Ultrasonography.