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S.Salehpour
Professor Ob/gyn
Infertility fellowship
Medical director
Gyn ward and IVF center
Taleghani hospital
SBMU
Tehran_ Iran
• Personilized medicine is important in the treatment of pain
• Future medication:
local neurogenesis
central sensitization
genetics
• 11%-%19 no reduction of pain
• 5%-59% pain remaining
• 17%-34% recurrence of pain after stop of therapy
• 5%-16% discontinuation because of adverse effect
• CONCLUSION: Limited or intermittent benefit for medical therapy of endometriosis pain
• GnRh or laparoscopic excision or ?ablation?
Increased pregnancy rate
• Lower oocyte number, lower quality, lower fertilization
• GnRh (3 months) before IVF , low evidence
• Depo progesterones ↑PR before IVF
Ovarian cystectomy
no improvement of ART outcome