Should we use dianogest or other medical treatment for minimizing the ectopic endometrial lesion before endometriosis surgery? If yes, how long and what is the dose?
Moreover, when an endometriosis patient has an indication for COH cycle or endometrial preparation for embryo transfer, and she is using dianogest, how should we manage this patient? After stop using dianogest, can we directly apply ART after the first menstrual bleeding?
Thank you for reading and looking forward to all your experience.
Best regard,
Please dont hesitate to discuss, looking forward to hearing from you!
According to the latest ESHRE guideline on the management of endometriosis, a Cochrane review on the preoperative hormonal treatment concluded that there was no evidence of a benefit of preoperative medical therapy on the outcome of surgery, but it also acknowledges that in clinical practice, surgeons prescribe preoperative medical treatment with GnRH analogues as this can facilitate surgery due to reduced inflammation, vascularisation of endometriosis lesions and adhesions. However, there are no controlled studies supporting this.
By the way, medical treatment should be offered preoperatively to women with painful symptoms in the waiting period before surgery, with the purpose of reducing pain before, not after, surgery.