Over 7 million women across the United States struggle with infertility. A new study reports a method of In Vitro Fertilization designed to provide hope for the 20-40% of women whose infertility stems from endometriosis. This new technique, called medroxyprogesterone acetate controlled ovarian hyperstimulation, or "MPA in COH" was recently published in the journal Nature Scientific Reports and shows promise for women struggling to get pregnant related to endometriosis.
Many times, IVF is done with Controlled Ovarian Hyperstimulation, or COH, which stimulated the production of eggs within many follicles. GnRh-a in IVF treatment has successfully been used to increase fertility in women struggling with endometriosis. GnRh-a treatment, however, is known to produce excess hormones like estrogen and progesterone--hormones that when in high levels are known to decrease a woman's likelihood to become pregnant. Since progesterone and synthetic progesterone, called progestins, are commonly used in IVF treatment for women with endometriosis, the GnRh-a and progestin treatments may counteract one another. In other words--common endometriosis treatments decrease the likelihood for women to create healthy eggs during Controlled Ovarian Hyperstimulation.
What researchers sought to do was find an alternative to progestin that would not counteract GnRh-a treatments, but would still have the same effects of mature egg creation. Their solution: MPA, or medroxyprogesterone acetate used in COH. The study looked at 224 women with advanced endometriosis who were already receiving COH. MPA was combined with human menopausal gonadotrophin, or hMG in hope that a woman receiving IVF with endometriosis could increase her chances of achieving a successful pregnancy. The study divided the women into three groups:
The study showed great results for the groups receiving MPA treatments. MPA in COH resulted in more mature eggs and healthier, higher-quality embryos within both test groups than in the control group. These mature, quality eggs are the results the researchers were looking to produce for their endometriosis patients. The fertilization, successful implantation, and pregnancy outcomes between the three groups were similar, and among both MPA groups, the egg and embryo outcomes were similar. MPA in COH, due to the success of this trial, is likely to be considered as an alternative to traditional GnRH-a treatments, meaning new hope for endometriosis patients struggling with infertility.
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