Analysis Of Related Factors Of Pregnancy And Pregnancy Outcome In Patients With Endometriosis After Surgery

BackgroundEndometriosis is a common benign gynecological disease,the recurrence rate is high,the main clinical manifestations are dysmenorrheal,infertility and sexual intercourse pain and other symptoms.Infertility has a serious impact on the physical and mental health and quality of life of patients with endometriosis.Research shows that the relationship between endometriosis and infertility is very close,according to statistics in endometriosis patients with infertility of nearly 30%-50%^[1].Therefore,how to improve patients with endometriosis clinical pregnancy defected rate becomes a research hotspot in the field of Obstetrics and Gynecology,but until now there is no unified understanding.Therefore,to study the factors affecting pregnancy after operation in patients with endometriosis,and to find out the relationship between the main factors and the pregnancy rate after operation of endometriosis,it is of great significance to improve postoperative pregnancy in patients with endometriosis.ObjectiveTo explore the related factors and correlation of postoperative pregnancy in patients with endometriosis,and to provide a scientific basis for clinical improvement of pregnancy rate in patients with endometriosis.MethodCases of endometriosis with infertility treated by laparoscopy from January 2010 to January 2016 in Puyang Maternal and Child Health-Care Hospital of Henan Province were retrospectively analyzed.Follow up 24 months after operation in 458 patients,56 cases of missing visit were included in the study,402 cases were included in the study.The selected patients were divided into two groups?pregnancy group and non-pregnancy group?according to whether they were pregnant or not.Clinical data of the patient's age,medical history,surgical procedure,ectopic site,lesion size,endometriosis fertility index?EFI?score,minimum function score?LF?,r-AFS staging?American Fertility Association modifies Endometriosis staging?,postoperative gonadotropin releasing hormone agonist,GnRH-?and pregnancy outcome were counted..The related factors of pregnancy outcome in patients with endometriosis after operation were analyzed.Results?1?The results of COX single factor analysis showed that:Age,age of infertility,r-AFS stage,type of infertility,lesion size,EFI score,IF score,postoperative GnRH-?treatment were the main factors affecting pregnancy outcome after operation in patients with endometriosis.?2?COX proportional risk multivariate regression analysis showed that:Age,infertile age,postoperative GnRH-?therapy were the influencing factors of postoperative pregnancy in patients with endometriosis.?3?Of 402 patients,235 cases had successful pregnancy after operation,the total pregnancy rate was 58.46%..The natural pregnancy rate of EFI score 0³ minutes group was 25.64%.The natural pregnancy rate of 4⁶ minutes group was 62.20%.The natural pregnancy rate of 7¹0 minutes group was73.91%.Tau-b=0.242,P=0.001.There was a positive correlation between natural pregnancy and EFI score in patients with endometriosis.?4?The natural pregnancy rate of patients in stage I of r-AFS stage I was 82.30%,the natural pregnancy rate of stage II was 75.47%,the natural pregnancy rate of stage III was41.18%and the natural pregnancy rate of IV was 24.69%.Tau-b=-0.267,P=0.001.There was a negative correlation between natural pregnancy and r-AFS stage after emt.?5?The natural pregnancy rate of GnRH-a group after emt was 82.67%,the natural pregnancy rate was34.00%in the group without Gn RH-a.The difference between the two groups was statistically significant?x²=26.365,P=0.000?.?6?There was no significant difference in cesarean section,spontaneous delivery between the GnRH-a group and the untreated GnRH-a group?P>0.05?.?7?The adverse outcome of GnRH-a drug treatment group?36 cases?was significantly lower than that of the untreated GnRH-a group?48.53%?,the difference was statistically significant?P<0.05?.Conclusion?1?Postoperative pregnancy in patients with endometriosis is related to age,infertile age and IF score,postoperative GnRH-?therapy.?2?There is a positive correlation between natural pregnancy and EFI score after operation in patients with endometriosis.There is a negative correlation between natural pregnancy and r-AFS stage after emt.?3?The treatment of GnRH-?in patients with endometriosis after operation may increase the rate of spontaneous pregnancy and decrease the incidence of adverse pregnancy.