Postoperative Long-term Maintenance Therapy with Oral Contraceptives, after Gonadotropin-releasing Hormone Analog Treatment in Women with Ovarian Endometrioma

Study Objective: The goal of this preliminary study was to assess the effect of cyclic monophasic oral contraceptives (OCs) as a postoperative long-term maintenance therapy (median 33.2 months) to suppress recurrence of endometrioma after conservative ovarian surgery followed by gonadotropin-releasing hormone (GnRH) analog treatment. Design: Retrospective clinical study (Canadian Task Force classification Pi-2). Setting: Adolescent and premarital clinic in a university hospital. Patients: The study was performed on 51 patients who underwent conservative surgery for endometrioma followed by GnRH analog treatment for 6 months. Interventions: We used cyclic monophasic OCs as maintenance therapy after surgical and medical treatment with GnRH analog for 6 months. Measurements and Main Results: Cyclic monophasic OCs were offered to young patients (n = 51, age = 24.1 +/- 2.8 years) who did not want to conceive immediately, to prevent the recurrence of endometrioma after conservative surgery with 6 cycles of postoperative GnRH analog treatment. During the long-term follow-up period (median 41.2; range 19-94 months), no recurrences of the endometrioma occurred in the current OC users. One patient showed a recurrence of endometrioma at 12 months after the discontinuation of the OCs. The median duration of OC administration was 33.20 months (range 12-86). In addition, 4 of 10 patients became pregnant within 12 months of discontinuing the long-term OC therapy. Conclusion: Postoperative long-term maintenance therapy with OCs can effectively suppress endometrioma recurrence in adolescent and young patients. Journal of Minimally Invasive Gynecology (2009) 167 34-39 (C) 2008 AAGL. All rights reserved.