Clinical Study On Ovarian Endometriosis

【Objective】 To explore the relationship between 15 factors such as primary dysmenorrhea, marriage age, parity, et al, and ovarian endometriosis; to investigate the value of ultrasonography and serum CA125 assay in diagnosis of ovarian endometriosis; to discuss the management of infertility associated with endometriosis.【Methods】 86 patients suffered from ovarian endometriosis and 90 patients suffered from benign adnexa mass were enrolled in this case-control study,15 related factors were analysed by unconditional logistic regression. The sensitivity and specificity of ultrasonography and serum CA125 assay as well as their tests in series and in paralle were calculated to evaluate their diagnostic value. The outcome of pregnancy in 23 patients associated with infertility treated by surgical and medical therapy were evaluated.【Result】 Menstrual cycle, primary dysmenorrhea, marriage age, parity, blood group entered regression model. The sensitivity of the test in series of ultrasonography and serum CA125 assay(30u/ml as positive value) was 73.26% , and its specificity 96.67%; The sensitivity of their test in paralle was 96.51%,and its specificity 71.11%. All patients were treated surgically. In 23 patients ,14 received abdominal surgery and 9 patients underwent the laparoscopic surgery; after surgery,5 out of the 12 treated with danazol , 3 out of the 7 with gestrinone,1 out of the 2 with goserelin and 1 out of the 2 with no medical treatment got pregnant.【Conclusion】 1.Long menstrual cycle and multiple parity are protective factors of endometriosis and primary dysmenorrhea, late marriage age, blood group A are risk factors; 2.Ultrasonography combined with serum CA125 assay(30u/ml as positive value) can improve the diagnosis rate of endometriosis of ovary. 3.Surgical therapy is beneficial for all stages of endometriosis. For patients of mild endometriosis associated with infertility ,laparoscopic surgery should be performed first, and then followed by expectation treatment; for moderate and severe patients, after surgery, administration of medical therapy(especially GnRHa) is helpful to increase pregnancy rate, and ovulation induction even assisted reproductive technologies are sometimes necessary.