|
|
|
| Effect of GnRH-a Treatment on Natural Pregnancy after Laparoscopic Endometriosis |
| YAN Hai-yan, WANG Mei |
| Department of Obstetrics and Gynecology,Shanghai Pudong New District People's Hospital, Shanghai 201299 |
|
|
|
|
Abstract 【Objective】To observe the effect of gonadotropin releasing hormone agonist (GnRH-a) on natural pregnancy after laparoscopic endometriosis. 【Methods】A total of 220 endometriosis patients diagnosed and treated in our hospital from October 2016 to October 2019 were selected and divided into the control group and the observation group according to the random number table method, with 110 cases in each group. Both groups were treated with laparoscopic surgery, while patients in the observation group received GnRH-a after laparoscopic endometriois. The patients were followed up for 36 months to compare the ovarian reserve function [the number of antral follicles, ovarian volume, and anti-Mullerian hormone (AMH) level], the number of natural pregnancy cases, postoperative natural pregnancy rate, and pregnancy outcome between the two groups of patients.【Results】The number of antral follicles in the observation group at 3 months and 6 months after the operation was significantly higher than that in the control group at the same period (P<0.05). There was no significant difference in ovarian volume between the two groups (P>0.05). There were 13 cases of hot flashes and 17 cases of bone mineral loss after operation in the observation group, the incidence of adverse reactions was 27.27%. The rate of natural pregnancy in the observation group at 24 months and 36 months was significantly higher than that in the control group (P<0.05). The pregnancy delivery rate, and the full-term delivery rate in the observation group were significantly higher than those in the control group 36 months after operation (P<0.05).However, the embryo developing arrest rateshowed no significant difference during 36-month follow-up between the two groups (P>0.05). The rate of premature delivery in the observation group was lower than that in the control group (P<0.05). The AMH level in the observation group was significantly higher than that in the control group at 24 months and 36 months after operation (P>0.05). 【Conclusion】Application of GnRH-a treatment in patients after laparoscopic endometriosis can promote the recovery of ovarian reserve function, increase the rate of natural pregnancy, and reduce the risk of fetal premature delivery.
|
|
Received: 02 December 2022
|
|
|
|
|
|
[1] 张银丽,何海娇,沈丹华.子宫体后壁息肉状子宫内膜异位症恶变1例[J].诊断病理学杂志,2020,27(2):141-142.
[2] 王秀娟,张静. 单孔腹腔镜治疗深部浸润型子宫内膜异位症的有效性和安全性[J].医学临床研究,2022,39(9):1433-1436.
[3] 李婷婷,翟旭华.子宫内膜异位症生育指数对异位症患者术后自然妊娠的预测价值[J].中国计划生育学杂志,2020,28(2):189-192.
[4] 王萨仁.子宫内膜异位症基因多态性的研究进展[J].医学研究生学报,2020,33(2):206-209.
[5] 范灵,熊正爱.卵巢型子宫内膜异位症患者生育力保护研究进展[J].中国妇幼保健,2020,35(8):1551-1554.
[6] 徐维娜,吴晓杰,陈校丹, 等.子宫内膜异位症生育指数评分用于子宫内膜异位症伴息肉患者的临床价值[J].中国妇幼保健,2020,35(2):296-299.
[7] 高航,陈洁,鲍青悦, 等.微创手术联合GnRH-a治疗EMs不孕患者疗效及对卵巢功能、炎症因子及妊娠结局影响[J].中国计划生育学杂志,2020,28(3):328-331.
[8] 郭敏,黄凌霄,陈聪, 等.基质金属蛋白酶在子宫内膜异位症患者中的表达水平及在盆腔粘连中的作用[J].中国妇幼保健,2020,35(8):1390-1392.
[9] 符琳鑫,陈秀芹.宫-腹腔镜联合GnRH-a治疗子宫内膜异位症合并不孕的临床疗效及影响因素分析[J].中国计划生育学杂志,2018,26(4):286-289.
[10] 冯银宏,陈桂丽,茅味蓉.子宫内膜异位症腹腔镜术后应用GnRH-a对患者生殖激素水平及复发风险的影响[J].中国妇幼保健,2021,36(8):1808-1811.
[11] 濮莲芳,金友存,蔡钱根, 等.重度子宫内膜异位症术后左炔诺孕酮宫内缓释系统联合GnRH-a辅助治疗效果[J].中国计划生育学杂志,2020,28(1):22-25.
[12] 吴琳,邓茂芳. GnRH-α联合桂枝茯苓丸对卵巢子宫内膜异位囊肿患者腹腔镜术后卵巢储备功能的影响[J].医学临床研究,2021,38(6):893-896.
[13] 黄菊,董梅,黄莉, 等.GnRH拮抗剂方案与激动剂方案在多囊卵巢综合征高反应患者的临床应用比较[J].实用医学杂志,2019,35(18):2909-2913.
[14] 许林敏,陈海棠,赵渊, 等.GnRH-a联合屈螺酮炔雌醇片对子宫腺肌病的疗效及对肿瘤标志物的影响[J].中国计划生育学杂志,2019,27(6):776-779. |
|
|
|
2023, Vol. 40 
