Effectiveness of laparoscopic surgery combined with gonadotrophin-releasing hormone agonist therapy in the treatment of endometrio-sis and its impact on recurrence and pregnancy status
Effectiveness of laparoscopic surgery combined with gonadotrophin-releasing hormone agonist therapy in the treatment of endometrio-sis and its impact on recurrence and pregnancy status
Objective To investigate the efficacy of postoperative application of gonadotropin releasing hormone agonist(GnRH-a)in patients with stage Ⅰ-Ⅲ endometriosis(EMS)after laparoscopic surgery and its impact on recurrence and pregnancy.Methods A total of 120 patients diagnosed as Ⅰ-Ⅲ EMS admitted to Wuhu First People's Hospital from January 2017 to June 2022 were included in this study and were divided into the GnRH-a group(n=69)and the control group(n=51)according to different treatment methods.The GnRH-a group re-ceived GnRH-a treatment after laparoscopic surgery,while the control group did not receive GnRH-a treatment after laparoscopic surgery.Sex hormones[including follicle stimulating hormone(FSH),luteinizing hormone(LH)]and endometrial thickness 3 months after treatment,ad-verse reactions,and 1-year postoperative recurrence rate,cumulative pregnancy rate and neonatal condition were compared.Results The levels of FSH and LH in the GnRH-a group at 3 months after treatment were(4.69±4.97)and(8.14±3.12)IU/L,respectively,which were lower than those in the control group[(8.95±4.02)and(13.52±3.29)IU/L],the differences were statistically significant(P＜0.05).The endo-metrial thickness of the GnRH-a group was(9.97±2.07)mm,which was higher than that of the control group[(9.21±1.79)mm],the difference was statistically significant(P＜0.05).There were no statistically significant differences in the overall incidence of adverse reactions and 1-year postoperative recurrence rate between the two groups(P＞0.05).The cumulative pregnancy rate of the GnRH-a group after treat-ment was 38.46％,which was higher than that of the control group(21.82％),the difference was statistically significant(P＜0.05).There were no statistically significant differences in live birth rate,miscarriage rate,multiple pregnancy rate,and ectopic pregnancy rate between the two groups(P＞0.05).There were no statistically significant differences between the two groups in terms of gestational age,premature delivery,de-livery method,and birth weight(P＞0.05).Conclusion The application of GnRH-a therapy after laparoscopic surgery can significantly im-prove the pregnancy rate in patients with stage Ⅰ-Ⅲ EMS,improve endometrial thickness and sex hormone levels,and has a relatively small im-pact on the occurrence of adverse reactions and the risk of recurrence.
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