Research About Clinical Effect Of Combined Gn Rha Therapy With Conservative Laparoscopic Operation And Recurrence-related Factors Of Ovarian Endometrioma

Objective: Combination treatment(medical treatment combined surgery)of endometriosis and related factors of recurrence is controversial.This research is to analyze curative effect of different treatment of conservative laparoscopy combined Gn RHa through pain relief,pregnancy and recurrence rate.To analyze the related factors of recurrence of endometrioma after laparoscopic excision.Method:Choosed 360 reproductive women who accepted laparoscopic conservative operation at Beijing Obstetrics and Gynecology Hospital from July 2012 to July 2014,confirmed by pathology for ovarian endometrioma.According to the American Fertility Society stages law,all were divided into III or IV stages.Subsequent follow-up was performed for two to three years,317 cases could follow up,missing rate was 11.94%.Essential information and postoperative pregnancy information were collected.Different groups were devided according to the usage of Gn RHa.Observedall case’s pain relief,pregnancy rate,recurrence rate,to compare therapeutic effect between different group.The clinical data of relapsed and non-relapsed cases were studied to analyzed the recurrence related factors of ovarian endometrioma.Results:The 25 th percentile of CA125 value of 302 patients was 18.35U/ml,the 75 th percentile was 52.5U/ml.There was no statistical diffenrence in ovarian cysts location distribution of asymptomatic patients,pain sufferers,infertile patients.There was no statistical difference in pain relief,pregnancy rate,recurrence rate between Gn RHa 3-month group,Gn RHa 6-month group after surgery and surgery alone group at 2-3 years after surgery(P>0.05).There was also no statistical difference in pain relief,pregnancy rate,recurrence rate between patients who undergone pre-or postoperative Gn RHa treatment,combination Gn RHa therapy before and after operation,LNG-IUS after surgery and surgery alone at 2-3 years after surgery(P>0.05).Logistic analysis showed that CA125 value was risk factor,while late menarche age was protective factor of ovarian endometrioma recurrence.The average age of postoperative patients conceived naturally was 29.32±3.75 years,while infertile patients was 31.86±4.40 years.11 patients(3.47%)went into menopause after surgery,whose average age was 48.18 years.27 patients’ menstrual cycle became irregular,38 patients’(11.99%)menstrual capacity decreased.18 patients’ menstrual period became shorter,while 3 patients’ longer.Conclusion:Laparoscopic may damage ovarian function and then cause menstrual disorder.There is not obvious difference between Gn RHa after surgery groups and surgery alone group in relieving pain at 2-3 years after surgery and decreasing recurrence rate,increasing pregnancy rate;also whether Gn RHa was used in combination with surgery and LNG-IUS was used after surgery has no especial advantage of the clinical curative effect at 2-3 years postoperatively.The CA125 value is the risk factors of ovarian endometrioma recurrence while late menarche age isprotective factor.The pregnancy rate after surgery is 69.86%.There is significant defference between the average age of the group who conceive naturally after surgery and the group who are infertile.It’s good for patients to seek pregnancy as soon as possible after treatment.