Effect Of Laparoscopic Surgery Combined With Medication On Pregnancy Rate And Recurrence Rate In Patients With Ovarian Endometriosis-related Infertility

Object:By collecting related research reports on combined drug therapy after laparoscopic surgery for infertility patients with cystic disease and adopting evidence-based medicine method,meta-analysis was conducted on the efficacy（pregnancy rate and recurrence rate）of combined drug therapy after laparoscopic surgery and pure laparoscopic surgery for infertility patients with cystic disease.To systematically evaluate the effect of laparoscopy combined with drug therapy on pregnancy rate and recurrence rate of infertility patients with cystic disease.Methods:Comprehensive retrieval of Chinese databases including CNKI,VIP,Wanfang data,etc.Retrieval of English databases including: Pub Med,EMbase,Cochran Library,etc.,supplemented by manual retrieval,searched for randomized controlled trials on the efficacy（pregnancy rate and recurrence rate）of laparoscopic surgery combined with drug therapy and laparoscopic surgery alone in the treatment of infertility patients with cystic disease.The retrieval time was up to June 30,2021.According to the inclusion criteria and exclusion criteria,two researchers strictly screened the literature,extracted data and evaluated its quality.Rev Man 5.3 software was used for statistical analysis of extracted data,and the conclusions were drawn.Result:The study included 12 literature（English 5,Chinese 7）,a total of1417 patients,including the control group of ovarian endometriosis cyst infertility after laparoscopic surgery a total of 532 patients,observation group on the basis of combined drug treatment a total of 885 patients,the two treatment methods of pregnancy rate and recurrence rate of meta-analysis,the results are as follows:1.For patients with ovarian endometriosis-related infertility,the pregnancy rate of laparoscopic surgery combined with Gn RH-a/gestrinone was higher than that of laparoscopic surgery alone,and the difference was statistically significant（OR=2.32,95%CI= [1.81 2.97],P <0.00001）.2.There was no significant difference in pregnancy rate between laparoscopic combined treatment（Gn RH-A/gestrinone）and laparoscopic alone in patients with stage I-II ovarian endometriosis-related infertility.（OR=0.97,95%CI= [0.58,1.61],P=0.90）.3.For patients with stage Ⅲ-Ⅳ ovarian endometriosis-related infertility,the pregnancy rate was higher with laparoscopy combined with Gn RH-a/gestrinone than with laparoscopy alone,and the difference was statistically significant（OR=3.20,95%CI= [1.84,5.57],P <0.00001）.4.For patients with ovarian endometriosis-related infertility,there was no significant difference in pregnancy rate between laparoscopic surgery combined with Gn RH-a and laparoscopic surgery combined with gestrinone（OR=1.16,95%CI=[0.63,2.12],P=0.64）.5.For ovarian endometriosis-related infertility patients,compared with laparoscopy alone,it was statistically significant（OR=0.35,95%CI=[0.24,0.53],P <0.00001）.Conclusion:1.For patients with clever balloon-related infertility,laparoscopic surgery combined with drug treatment is more beneficial to improve pregnancy rate and reduce recurrence rate than laparoscopic surgery alone.2.Laparoscopic surgery combined with gestational trimenenone and laparoscopic surgery combined with Gn RH-a is quite effective in improving the pregnancy rate in patients.3.Laparoscopic surgery combined with drug treatment will not increase the pregnancy rate of patients with stageⅠ-Ⅱovarian endometriosis-related infertility compared with laparoscopic surgery alone,but it will increase the pregnancy rate of patients with Ⅲ-Ⅳ ovarian endometriosis-related infertility.