Indian Woman TTC For 3 Years, Has Endo: Danazole Or Lupron Therapy?

Question:

I am tryiong to concieve last 3 years. I did on 6 January 2011 report as follows:

H-Lap, D&C/ PT(HPE) done

Hysteroscopy--Ut cavity regular canal narmal B/L ostia seen.

Laproscopy-- Ut normal size. retroverted congestion, Small Seedling fibroid, both ovaries are normal size and healthy.

Both Tubes Patents and healthy.

B/L adhesions, Endometriotic patches seen on both sides.

Now i completed 2 months course with DANAZOLE (200) which i am taking daily twice, only one month left. after laparascopy on 6 jan my period come after 21 days i.e. on 27 of Jany and i started Danazole Therapy on 17 of Jan. but still my periods not come almost 18 days left.

I asked the doctor she said some women concieve with Danazole also and some may not, so first complete the course of one month then try to concieve with Letrofil and all medicine.

But now i am thinking i dont want to waste time so instead of continue with Danazole i want to take LUPRON Depo Injection. Please guide me is it right ? Or good for me altough its expensive,. Please tell me should i take only one injection of Lupron or more than one becoze already i completed 2 months course with Danazole. Also, when my period expected and when should i try to concieve doctor, i m very much crazy about child.

Thank you. S. From India

Answer:

Hello S. from India,

Danazol is a medication that is given for the treatment of endometriosis. It inhibits estrogen production and therefore ovarian function. Because of this ovulation will usually be inhibited and pregnancy is not possible. It will also cause you to not have periods. Sometimes you will get breakthrough (irregular) bleeding in the first cycle but by the second and third cycle, the periods will stop.

Lupron is another similar medication. It is slightly chemically different but does the same thing. I like the Lupron because it has less side effects than Danazol. Danazol is really an older treatment. We rarely use that anymore in the U.S. Instead, Lupron depot can be given as a 3.75 mg monthly dose for three months or an 11.25 mg single dose that lasts for three months.

Once you finish the three month therapy of either of these medications, you can begin trying for pregnancy. I would recommend aggressive treatment with either ovulation induction and IUI or IVF. You will have about a 6 month window before the endometriosis will return again. Endometriosis is usually given a stage from 1-4. If you have stage 3 or 4 endometriosis, you should go directly to IVF as the treatment of choice. If it is stage 1or 2, then IUI would be appropriate.

Good luck,

Edward J. Ramirez, M.D., FACOG

Executive Medical Director

The Fertility and Gynecology Center

Monterey Bay IVF Program

www.montereybayivf.com