Danazol for treating subfertility

Hughes E, Brown J, Tiffin G

Published Online:

January 21, 2009

The drug danazol (Danocrine) was the most frequently prescribed medication for endometriosis but has also been tested as a treatment for unexplained subfertility. The review of trials found that there is no evidence that low doses of danazol improve live births/ ongoing pregnancy rates. Other negative factors include adverse effects.

Abstract (click to read)

Background:

The synthetic androgen Danazol, was developed in the 1970's as a treatment for endometriosis. Its use was soon advocated in women with unexplained subfertility. Two randomised trials were subsequently conducted to assess the effectiveness of danazol in this population.

Objectives:

The objective of this review was to assess the effect of danazol on live birth rate in women with unexplained subfertility.

Search strategy:

We searched the Cochrane Menstrual Disorders and Sub-fertility Group's specialised register of trials (searched November , 2006) the Cochrane Register of Controlled Trials (The Cochrane Library, Issue 4, 2006), MEDLINE (1966-November 2006), EMBASE (1980 - November 2006) and reference lists of articles.

Selection criteria:

Randomised trials of danazol compared with placebo or no treatment in women with unexplained subfertility.

Data collection and analysis:

Data were extracted by two reviewers EH and GT.

Main results:

Two trials involving seventy-one women were included. There was no statistically significant difference in the live birth/ ongoing pregnancy rate between danazol and placebo at the end of treatment (OR 1.16, 95% CI 0.0 to 8.29; p=0.36) or at the end of follow-up (OR 2.41; 95% CI 0.59 to 9.82; p=0.22). There was no significant difference in clinical pregnancies following treatment (OR 0.14, 95% CI 0.01 to 2.26; p=0.17), however there were significantly more clinical pregnancies during the follow-up period in the danazol group compared with the placebo group (OR 3.15, 95%CI 0.98 to 10.10; p<0.05). Multiple side effects were reported.

Authors' conclusions:

Available data demonstrate no evidence of the benefit of danazol for unexplained subfertility. Although there is insufficient evidence to be certain of this, the need for contraception during treatment and the adverse effects and costs of danazol, make its use for this problem unwarranted. The increased pregnancy rate in the long term follow-up data may be attributable to additional therapies and did not influence the live birth/ongoing pregnancy data.

This record should be cited as:

Hughes E, Brown J, Tiffin G. Danazol for unexplained subfertility. Cochrane Database of Systematic Reviews 2007, Issue 1. Art. No.: CD000069. DOI: 10.1002/14651858.CD000069.pub2

Assessed as up to date:

November 15, 2006

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Primary Review Group:

Menstrual Disorders and Subfertility Group

Health topics:

Gynaecology > Subfertility > Female: unexplained

Cochrane Summaries^beta

Independent high-quality evidence for health care decision making

Danazol for treating subfertility

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