Gonadotropin-releasing hormone agonist plus “add-back” hormone replacement therapy for treatment of endometriosis: a prospective, randomized, placebo-controlled,

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Gonadotropin-releasing hormone agonist plus “add-back” hormone replacement therapy for treatment of endometriosis: a prospective, randomized, placebo-controlled, double- blind trial Henk R Franke, M.D., Ph.D., Peter H.M van de Weijer, M.D., Ph.D., Ton M.M Pennings, M.D., Marius J van der Mooren, M.D., Ph.D. Fertility and Sterility Volume 74, Issue 3, Pages 534-539 (September 2000) DOI: 10.1016/S0015-0282(00)00690-7

Figure 1 Mean revised American Fertility Society (AFS-R) score, before treatment (white bars) and after 24 weeks of treatment (black bars), in patients receiving GnRH agonist plus placebo or GnRH agonist plus HRT with 17β-E2 norethisterone acetate. The decrease in AFS-R differed significantly within groups (P<.05) but not between the groups (P=.54). Franke. GnRH agonist treatment of endometriosis. Fertil Steril 2000. Fertility and Sterility 2000 74, 534-539DOI: (10.1016/S0015-0282(00)00690-7)

Figure 2 Bone mineral density of the lumbar spine (L2 to L4) in patients receiving GnRH agonist plus placebo (black square) or GnRH agonist plus HRT with 17β-E2 norethisterone acetate (white circles). After 24 weeks of treatment, bone mineral density decreased 5.02% in the GnRH agonist plus placebo group and increased 0.18% in the GnRH agonist plus HRT group. (difference between groups, P<.001). Franke. GnRH agonist treatment of endometriosis. Fertil Steril 2000. Fertility and Sterility 2000 74, 534-539DOI: (10.1016/S0015-0282(00)00690-7)

Figure 3 Total Kupperman index score before treatment and at 4, 12, and 24 weeks after initiation of therapy in patients receiving GnRH agonist plus placebo (black squares) or GnRH agonist plus HRT with 17β-E2 norethisterone acetate (white circles). In the GnRH agonist plus placebo group, the Kupperman index score decreased by 75% at 4 weeks, 129% at 12 weeks, and 113% at 24 weeks (P=.0004). The difference between groups at 24 weeks was statistically significant (P=.003). Franke. GnRH agonist treatment of endometriosis. Fertil Steril 2000. Fertility and Sterility 2000 74, 534-539DOI: (10.1016/S0015-0282(00)00690-7)