Experience with a depot GnRH-agonist (Zoladex) in the treatment of genital endometriosiss

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Abstract
Eighty patients with different stages of genital endometriosis were treated with Zoladex, a gonadotrophin-releasing hormone analogue in a depot formulation, injected subcutaneously every 4 weeks. The stages of endometriosis (I-IV) were classified according to the revised American Fertility Society recommendations (AFS criteria) via pelviscopy before and after 6 months of treatment. Fifty-eight second-look pelviscopies were performed with the following objective changes after (before) treatment: Stage IV 0 (3); Stage III, 2 (13); Stage II, 12 (30); Stage I, 19 (12). Twenty-five patients presented with Stage 0 after therapy and were healed. All 57 symptomatic patients showed a subjective response to Zoladex therapy with a significant decrease of the total pelvic symptom score. Thirty-eight patients with infertility wished to become pregnant and so far 16 (40%) have conceived. During therapy, the serum concentrations of luteinizing hormone, follicle stimulating hormone, oestradiol and progesterone were significantly suppressed. All patients were amenorrhoeic after 1–2 injections. Restoration of ovarian function with resumption of menstruation occurred within 57–92 days after the last injection of Zoladex (1–2 months after end of treatment). Side-effects were minimal and were those expected of the hypo-oestrogenic state, such as hot flushes, vaginal dryness and decrease of libido.

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