Comparison Of Efficacy Among In-vitro Fertilization, Gonadotropin-releasing Hormone Agonist And Laparoscope In The Endometriosis Combined With Infertility

Objectives: To investigate the efficacy of the three kinds of protocolgenerally applied in the treatment of endometriosis combined withinfertility, and the standard and the opportunity for choosing the protocol. Methods: 203 endometriosis combined with infertility patients with atleast lateral fallopian tube unobstructed were enrolled. 1) There were 81cases in laparoscope group, in which electrocoaqulating the endometrioticimplants, cleaning the pelvisi and loosing the adhesion were done. Weinstructed the postoperative patients about their sexual intercourse in theirfollowing twelve menstrual cycles. 2) There were 72 cases inGonadotropin-releasing Hormone Agonist (GnRHa) group, in whichlong-effective GnRHa was injected for 3 to 4 months after the laparoscopeoperation, then we instructed the patients the same way as we did in thelaparoscope group. 3) There were 50 cases in in-vitro fertilization (IVF)group, in which we carried out IVF in the postoperative patients at once.We compare the total pregnancy rate (PR) in three groups, in each stageclassified by r-AFS, and in the accumulated PR. Results: 1) Total PR in IVF group was 36.0% (18/50). Compared with32.1% (26/81) in laparoscope group and 31.9% (23/72) in GnRHa group, itwas high obviously (p1,2 <0.01). 2) In the patients with endometriosis instage â…¢-â…£, the PR still kept as high as 34.8%, whereas the PR inlaparoscope group and GnRHa group both declined, but we could not findthe statistically significance between them. 3) After 6 therapy cycles, theaccumulated PR in GnRHa group was 30.6% (22/72), which is approachingthe total PR extremely. But in laparoscope group, after 9 therapy cycles, theaccumulated PR was 29.6% (24/81), which was just near to it's total PR. Conclusions: In the patients with endometriosis in stageâ… â…¡, wechoose only laparoscope first; If possible, we should confine IVF protocolwithin the stage â…¢,â…£; GnRHa protocol appear not to be the first choicein each stage. After laparoscope operation, if the patients are still unable toconceive for12 menstrual cycles, and after GnRHa was stopped , thepatients can not conceive for 6 menstrual cycles, we should carry outtherapy of IVF for them at once.