Você pesquisou por y - Revista Brasileira de Ginecologia e Obstetrícia

PURPOSE: to verify the effects of intrauterine levonorgestrel device (IUD) in women with adenomyosis, with implantation failure in previous in vitro fertilization (IVF) cycles. METHODS: eighty infertile women with ages up to 38 years, who had adenomyosis diagnosed by ultrasonography and MRI were selected. All the women presented antecedents of one or more tormer IVF attempts without success due to implantation failure. The women were subdivided into IUD Group, composed of 40 women with an IUD that released 20 µg of levonorgestrel/day during six months, preceding a new IVF cycle, and IVF Group, also composed of 40 women, who were directly submitted to a new IVF cycle without previous adenomyosis treatment. In the IUD Group the uterine volume, thickness and hypersignal foci of the junctional zone were assessed before and after treatment, as well as the pregnancy rates in the new IVF cycle, compared to the data obtained with the IVF Group. Statistical analyses were performed adopting the significance level of 5% (p<0,05), using the Mann-Whitney and Sudent's t tests. RESULTS: after treatment, there was a reduction of 77.7% in the cases of focal adenomyosis, in addition to a significant reduction of the uterine volume and of the mean thickness of the junctional zone from 128.8 to 93.6 ml and from 12.3 to 11.3 mm, respectively. In the IUD Group, pregnancy rate reached 30%, which was higher than, but not significantly different from that of the IVF group, which was 17.5%. CONCLUSION: the use of an IUD with levonorgestrel may be administered prior to IVF cycles in patients with adenomyosis who suffered previous implantation failure.