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MPA in COH as a solution to Endometriosis Patients using IVF
October 14, 2017
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.
Typical IVF for women with endometriosis uses Gonadotropin-releasing hormone agonist, or GnRh-a, to assist in egg implantation, but produces hormones that weigh against a woman's likelihood to become pregnant.
In this study, Medroxyprogesterone Acetate, or MPA, proved a worthy alternative to progestin used in COH during IVF when combined with human menopausal gonadotrophin, or hMG.
Treatment led to more mature eggs and higher quality embryos in women with endometriosis.
The Problem with Traditional COH in Endometriosis Patients
Over-production of Hormones Counteractive in GnRh-a Treatments
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.
MPA in COH for Endometriosis Patients Receiving IVF: A Study
Researchers Look for Solution to Create Healthy Eggs in Endometriosis Patients
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:
MPA in COH patients who underwent surgery for cysts called "ovarian endometrioma"
MPA in COH patients who underwent aspiration for cyst removal
MPA in COH Shows Hope for Healthier, Mature Eggs
A Potential Solution to Increase Pregnancy Rates for Women with Endometriosis
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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