Benefit of GnRH Agonist Before Frozen Embryo Transfer in Patients With Endometriosis and/or Adenomyosis

Endometriosis reveals the presence of glands or endometrial stroma outside the uterus, responsible for pain and infertility. Adenomyosis illustrates an invagination of endometrial islets within the myometrium, leading to a disturbance of its contractile activity, also potentiated by local hyperestrogenism.

These two pathologies are often associated, and express an alteration of the eutopic endometrium by pro-inflammatory markers responsible for a lower implantation rate.

GnRH agonists are known to decrease these pro-inflammatory markers (cytochrome P450 and Cox 2 aromatase) in the eutopic endometrium of women with endometriosis or adenomyosis.

Patients will received 1 or 2 injection of GnRH delay agonist (Decapeptyl 3mg) approximately 1 month before the frozen embryo transfer.

Inclusion criteria

• Women aged 18 to 36 years (women ≥18 years to <36 years) with endometriosis and / or adenomyosis
• Having benefited from In vitro fertilisation /intracytoplasmic micro-injection with freeze all and for whom the frozen embryon transfer of a blastocyst is planned
• A normal uterine cavity
• An MRI showing endometriosis and / or adenomyosis during the inclusion visit
• Having signed a consent form
• Being affiliated to a Health Insurance Plan.

Exclusion criteria

• Patient aged <18 years and ≥ 36 years
• BMI> 35
• History of implantation failures (≥ 2)
• Endometrial alterations: synechiae, polyps, myomas, hyperplasia, hematometra
• known hydrosalpinx uni or bilateral
• MRI showing no endometriosis or adenomyosis
• Hypersensitivity to GnRH, GnRH analogues, or any of the excipients of Decapeptyl 3 mg
• Known hypersensitivity to estradiol
• Known hypersensitivity to progesterone
• Known hypersensitivity to acetylsalicylic acid or other nonsteroidal anti-inflammatory drugs
• Known hypersensitivity to folic acid
• Known hypersensitivity to cefixime or an antibiotic in the cephalosporin group
• Known hypersensitivity to levofloxacin or any other quinolone
• History of tendinopathies related to the administration of fluoroquinolones
• Epilepsy
• Hypersensitivity to contrast agents for MRI
• Known or suspected breast cancer or history of breast cancer
• Known or suspected genital tract cancer or history of genital cancer
• known or suspected estrogen-dependent malignant neoplasms
• Undiagnosed genital haemorrhage
• Untreated endometrial hyperplasia
• History of idiopathic venous thrombo-embolic accident or evolving venous thrombo-embolic event (deep vein thrombosis, pulmonary embolism)
• Recent or evolving arterial thromboembolic stroke (eg angina, myocardial infarction)
• Acute liver disease or history of liver disease, until hepatic tests are normalized
• Severe renal insufficiency
• Severe, uncontrolled heart failure
• Evolutionary gastroduodenal ulcer
• History of asthma caused by the administration of salicylates or substances of similar activity, especially nonsteroidal anti-inflammatory drugs
• GnRH Agonist Decapeptyl administered within 6 months prior to transfer
• To be deprived of liberty or under guardianship
• Pregnancy and breast feeding.