Dmowski, W. P., Radwanska, E., Binor, Z., & Rana, N. (1986). Mild endometriosis and ovulatory dysfunction: effect of danazol treatment on success of ovulation induction. Fertility and Sterility, 46(5), 784-789. https://doi.org/10.1016/s0015-0282(16)49811-0
Dmowski WP, Radwanska E, Binor Z, Rana N. Mild endometriosis and ovulatory dysfunction: effect of danazol treatment on success of ovulation induction. Fertil Steril. 1986;46(5):784-789. doi:10.1016/s0015-0282(16)49811-0
Dmowski, W. Paul, et al. "Mild endometriosis and ovulatory dysfunction: effect of danazol treatment on success of ovulation induction." Fertility and Sterility, vol. 46, no. 5, 1986, pp. 784-789.
For EndNote, Zotero or Mendeley:
Open access
Free to read
No reuse license
Free to read at the publisher (reported by Unpaywall and OpenAlex, not verified by RRM Academy)
Author affiliations
1 institution
University of Arkansas for Medical Sciences00xcryt71
Linked to ROR, the Research Organization Registry
RRM Academy Synopsis
Mild endometriosis may affect conception beyond ovulation problems
With ovulation induction, 7 out of 10 women conceived after danazol and nearly 3 out of 10 without it. This 1986 study covered 52 women with stage I or II endometriosis and ovulation problems, some treated with danazol first. The authors conclude that mild endometriosis may affect conception in more ways than ovulation.
Key Findings
Ovulation was absent in 9% of 450 women with endometriosis (42 of 450). Luteinized unruptured follicle (LUF) syndrome affected 34% of 142 women (48 of 142).
Without danazol, 10 of 36 women (27.8%) conceived with ovulation induction, at an average of 17.6 induction cycles per pregnancy.
After danazol, 21 of 30 women (70%) conceived, at an average of 4.5 cycles per pregnancy. The authors report P < 0.001 for the difference.
Of 14 women who did not conceive without danazol and then crossed over, 9 (64.3%) conceived after danazol, similar to the rate in the danazol group overall.
First-trimester miscarriage rates were 20% in the group without danazol and 14% in the danazol group, a difference the authors report as not significant.
Interpretation
The authors compared two groups at Rush Medical College in Chicago. Women chose their own group. Fourteen of the 30 women in the danazol group had first tried ovulation induction without it. Participants had stage I or stage II endometriosis, no adhesions or endometriomas, and partners with adequate semen. The authors note that randomization would have made the results more convincing. They believe it would not have changed the results much, because women who crossed over conceived at a similar rate.
RRM Context
In luteinized unruptured follicle syndrome, tests show ovulation, but the egg stays trapped in the follicle. Of 142 women with endometriosis confirmed at surgery, 48 had it. Danazol is a suppressive medication. Restorative reproductive medicine looks for the cause and treats the disease itself.
Our editorial summary of this paper, not the article's abstract.
Abstract
The effectiveness of ovulation induction with clomiphene citrate or human menopausal gonadotropins was evaluated in 52 infertile women with stage I or stage II endometriosis and ovulatory dysfunction: anovulation or luteinized unruptured follicle (LUF) syndrome before (group I) and after (group II) danazol treatment. The incidence of anovulation and LUF in the endometriosis population was 9% and 34%, respectively. In group I, 10 of 36 patients (27.8%) conceived, with an average of 17.6 induction cycles per pregnancy. In group II, 21 of 30 patients (70%) conceived, with an average of 4.5 cycles per pregnancy (difference significant at P less than 0.001). There was no difference in the average number of ovulation induction cycles per patient between groups I and II (4.9 and 3.1, respectively). Of 14 patients who did not conceive in group I and crossed over to group II, 9 (64.3%) conceived (not different from group II). Spontaneous abortion rates were 20% in group I and 14% in group II. These results indicate that mild endometriosis may interfere with conception through mechanisms other than ovulatory dysfunction and that treatment with danazol appears to more than double the fertility rate.
00xcryt71 