5th International Conference on Gynecology and Obstetrics

Nur Wa Bushra Jahan passed her MBBS from Dhaka Medical College in 2002 and completed FCPS (Gynaecology & Obstetrics) in 2013 from Bangladesh College of Physicians and Surgeons. She is an Assistant Professor in the Department of Reproductive Endocrinology and Infertility, Bangladesh Medical University. She has 13 publications. She has special interests in the field of reproductive medicine.

Background: Adenomyosis is an emerging enigmatic uterine disease that negatively impacts women's fertility. Conservative treatments, including medical management, offer hope to preserve future fertility but remain challenging, especially in low-resource settings. Since 2019, at our center, infertile women diagnosed with symptomatic adenomyosis have been pre-treated with either a Levonorgestrel-Releasing Intrauterine System (LNG-IUS) or Dienogest based on physician preference. Following symptomatic relief, ovarian stimulation protocols were applied to optimize the chances of natural conception without Assisted Reproductive Technologies (ART). This study aimed to compare fertility outcomes following ovarian stimulation in infertile women with symptomatic adenomyosis who had been pre-treated with LNG-IUS versus Dienogest.

Methods: This quasi-experimental study was conducted at Bangladesh Medical University (BMU), Dhaka, from January 2024 to December 2024. Infertile women with previously diagnosed symptomatic adenomyosis, symptomatically relieved by LNG-IUS or Dienogest, were enrolled. Following enrolment, LNG-IUS devices were removed and Dienogest was discontinued. Participants were divided into two groups: Group A (pre-treated with LNG-IUS) and Group B (pre-treated with Dienogest) and both underwent ovarian stimulation using oral ovulogens.

Results: Both groups were comparable in baseline socio demographic, biochemical and biophysical criteria. Ovulation and pregnancy rate in each cycle were higher in LNG-IUS group than Dienogest group though this difference was not statistically significant (p>0.05).

Conclusions: Pre-treatment with LNG-IUS prior to ovarian stimulation may offer better fertility outcomes compared to Dienogest, though larger studies involving more cycles and multicenter collaboration are necessary to confirm these findings.