Download PDF
Semin Reprod Med 2013; 31(02): 150-153
DOI: 10.1055/s-0032-1333480
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Impact of Superovulation for Women with Endometriosis

Shahryar K. Kavoussi
1   Austin Fertility and Reproductive Medicine/Westlake IVF, Austin, Texas
› Author Affiliations
Further Information

Publication History

Publication Date:
27 February 2013 (online)

    Permissions and Reprints

Abstract

Superovulation (SO)/Intrauterine insemination (IUI) has been used as a treatment approach for endometriosis-associated infertility. The existing medical literature regarding SO in endometriosis patients is composed of heterogeneous studies that differ in terms of study design, SO protocols, the addition of IUI, and comparison groups. There is a need for more well-designed studies to further investigate the efficacy of SO in women with endometriosis-associated infertility. Although in vitro fertilization (IVF) is most effective and is significantly superior to other treatments in endometriosis patients, most of the existing studies suggest some benefit of SO/IUI in infertility patients with early-stage disease. Therefore, SO/IUI is a reasonable early fertility treatment option for women with endometriosis who desire a short trial of potentially more cost-effective treatment options prior to pursuing an IVF cycle and those for whom IVF is not a feasible or desirable option. It appears that gonadotropins are most effective for SO in this patient population even though more head-to-head comparisons are needed.

Keywords

endometriosis - superovulation - infertility - ovulation induction - intrauterine insemination
 

  • References

  • 1 Abu Hashim H, El Rakhawy M, Abd Elaal I. Randomized comparison of superovulation with letrozole vs. clomiphene citrate in an IUI program for women with recently surgically treated minimal to mild endometriosis. Acta Obstet Gynecol Scand 2012; 91 (3) 338-345
    CrossrefPubMedGoogle Scholar
  • 2 Cahill DJ. What is the optimal medical management of infertility and minor endometriosis? Analysis and future prospects. Hum Reprod 2002; 17 (5) 1135-1140
    CrossrefPubMedGoogle Scholar
  • 3 Mahmood TA, Messinis IE, Templeton A. Follicular development in spontaneous and stimulated cycles in women with minimal-mild endometriosis. Br J Obstet Gynaecol 1991; 98 (8) 783-788
    PubMedGoogle Scholar
  • 4 Loh SK, Leong NK. Superovulation-intrauterine insemination: an additional tool in the treatment of infertility. Singapore Med J 1996; 37 (1) 66-68
    PubMedGoogle Scholar
  • 5 Singh M, Goldberg J, Falcone T , et al. Superovulation and intrauterine insemination in cases of treated mild pelvic disease. J Assist Reprod Genet 2001; 18 (1) 26-29
    CrossrefPubMedGoogle Scholar
  • 6 Reindollar RH, Regan MM, Neumann PJ , et al. A randomized clinical trial to evaluate optimal treatment for unexplained infertility: the Fast Track and Standard Treatment (FASTT) trial. Fertil Steril 2010; 94 (3) 888-899
    CrossrefPubMedGoogle Scholar
  • 7 Senapati S, Barnhart K. Managing endometriosis-associated infertility. Clin Obstet Gynecol 2011; 54 (4) 720-726
    CrossrefPubMedGoogle Scholar
  • 8 Schwartz D, Mayaux MJ. Female fecundity as a function of age: results of artificial insemination in 2193 nulliparous women with azoospermic husbands. Federation CECOS. N Engl J Med 1982; 306 (7) 404-406
    CrossrefPubMedGoogle Scholar
  • 9 Hughes EG, Fedorkow DM, Collins JA. A quantitative overview of controlled trials in endometriosis-associated infertility. Fertil Steril 1993; 59 (5) 963-970
    PubMedGoogle Scholar
  • 10 Practice Committee of the American Society for Reproductive Medicine. Endometriosis and infertility: a committee opinion. Fertil Steril 2012; 98 (3) 591-598
    CrossrefPubMedGoogle Scholar
  • 11 Collins JA, Burrows EA, Wilan AR. The prognosis for live birth among untreated infertile couples. Fertil Steril 1995; 64 (1) 22-28
    PubMedGoogle Scholar
  • 12 Jansen RPS. Minimal endometriosis and reduced fecundability: prospective evidence from an artificial insemination by donor program. Fertil Steril 1986; 46 (1) 141-143
    PubMedGoogle Scholar
  • 13 Hammond MG, Jordan S, Sloan CS. Factors affecting pregnancy rates in a donor insemination program using frozen semen. Am J Obstet Gynecol 1986; 155 (3) 480-485
    PubMedGoogle Scholar
  • 14 Matorras R, Corcóstegui B, Esteban J , et al. Fertility in women with minimal endometriosis compared with normal women was assessed by means of a donor insemination program in unstimulated cycles. Am J Obstet Gynecol 2010; 203 (4) e1-e6
    PubMedGoogle Scholar
  • 15 Isaksson R, Tiitinen A. Superovulation combined with insemination or timed intercourse in the treatment of couples with unexplained infertility and minimal endometriosis. Acta Obstet Gynecol Scand 1997; 76 (6) 550-554
    CrossrefPubMedGoogle Scholar
  • 16 Werbrouck E, Spiessens C, Meuleman C, D'Hooghe T. No difference in cycle pregnancy rate and in cumulative live-birth rate between women with surgically treated minimal to mild endometriosis and women with unexplained infertility after controlled ovarian hyperstimulation and intrauterine insemination. Fertil Steril 2006; 86 (3) 566-571
    CrossrefPubMedGoogle Scholar
  • 17 Dmowski WP, Pry M, Ding J, Rana N. Cycle-specific and cumulative fecundity in patients with endometriosis who are undergoing controlled ovarian hyperstimulation-intrauterine insemination or in vitro fertilization-embryo transfer. Fertil Steril 2002; 78 (4) 750-756
    CrossrefPubMedGoogle Scholar
  • 18 Peterson CM, Hatasaka HH, Jones KP, Poulson Jr AM, Carrell DT, Urry RL. Ovulation induction with gonadotropins and intrauterine insemination compared with in vitro fertilization and no therapy: a prospective, nonrandomized, cohort study and meta-analysis. Fertil Steril 1994; 62 (3) 535-544
    PubMedGoogle Scholar
  • 19 Allaire C. Endometriosis and infertility: a review. J Reprod Med 2006; 51 (3) 164-168
    PubMedGoogle Scholar
  • 20 Karabacak O, Kambic R, Gursoy R, Ozeren S. Does ovulation induction affect the pregnancy rate after laparoscopic treatment of endometriosis?. Int J Fertil Womens Med 1999; 44 (1) 38-42
    PubMedGoogle Scholar
  • 21 Chaffkin LM, Nulsen JC, Luciano AA, Metzger DA. A comparative analysis of the cycle fecundity rates associated with combined human menopausal gonadotropin (hMG) and intrauterine insemination (IUI) versus either hMG or IUI alone. Fertil Steril 1991; 55 (2) 252-257
    PubMedGoogle Scholar
  • 22 Nulsen JC, Walsh S, Dumez S, Metzger DA. A randomized and longitudinal study of human menopausal gonadotropin with intrauterine insemination in the treatment of infertility. Obstet Gynecol 1993; 82 (5) 780-786
    PubMedGoogle Scholar
  • 23 Tummon IS, Asher LJ, Martin JS, Tulandi T. Randomized controlled trial of superovulation and insemination for infertility associated with minimal or mild endometriosis. Fertil Steril 1997; 68 (1) 8-12
    CrossrefPubMedGoogle Scholar
  • 24 Fedele L, Bianchi S, Marchini M, Villa L, Brioschi D, Parazzini F. Superovulation with human menopausal gonadotropins in the treatment of infertility associated with minimal or mild endometriosis: a controlled randomized study. Fertil Steril 1992; 58 (1) 28-31
    PubMedGoogle Scholar
  • 25 Deaton JL, Gibson M, Blackmer KM, Nakajima ST, Badger GJ, Brumsted JR. A randomized, controlled trial of clomiphene citrate and intrauterine insemination in couples with unexplained infertility or surgically corrected endometriosis. Fertil Steril 1990; 54 (6) 1083-1088
    PubMedGoogle Scholar
  • 26 Guzick DS, Carson SA, Coutifaris C , et al; National Cooperative Reproductive Medicine Network. Efficacy of superovulation and intrauterine insemination in the treatment of infertility. N Engl J Med 1999; 340 (3) 177-183
    CrossrefPubMedGoogle Scholar