| Objective: The pregnancy outcome and recurrence rate after 1 year of laparoscopic surgery and laparoscopy combined with Gn RH-alpha in the treatment of endometriosis and infertility were compared to explore whether combined Gn RH-alpha therapy can improve the natural pregnancy rate and reduce the recurrence rate in patients with endometriosis and infertility.Methods:We selected 110 patients with endometriosis infertility who met the inclusion criteria in our hospital from October 2015 to October 2016.Intraoperative ASRM modified endometriosis staging method(r-AFS)was divided into two groups: stage I and II,stage III and IV.Randomly divided into control group of 55 cases(simple laparoscopic treatment)and observation group of 55 cases(postoperative laparoscopic treatment with Gn RH-alpha).In the observation group after 3-5 days subcutaneous injection of Gn RH-a(Leuprorelin Acetate Microspheres for Injection 3.75mg),after every 28 days injection once,a total of 3 times,the control group after surgery expecting treatment.Both groups of patients began to calculate the pregnancy time after recovery of menstruation.Postoperative patients were followed up by telephone and outpatient-visited within 6 months and 6-12 months of pregnancy and recurrence rate.Results:(1)The cumulative pregnancy outcomes were compared between the two groups.In the observation group,there were 28 cases of pregnancy,2cases of early spontaneous abortion,1 case of ectopic pregnancy and 20 cases of infertility.In the control group,there were 24 cases of pregnancy,4 cases of early spontaneous abortion,2 cases of ectopic pregnancy,and 25 cases of infertility.There was no significant difference in the total pregnancy rate between the two groups(P > 0.05).There was no significant difference in spontaneous abortion rate and ectopic pregnancy between observation group and control group(P> 0.05).It is suggested that postoperative laparoscopic surgery combined with Gn RH-a in infertile women with endometriosis cannot effectively improve the pregnancy rate,nor can it improve pregnancy outcomes.(2)The pregnancy outcomes of patients in stage I and II of observation group and control group were compared.In the control group,there were 15 cases of pregnancy,14 cases of intrauterine pregnancy,1 case of ectopic pregnancy,3cases of early spontaneous abortion,17 cases of pregnancy in the observation group,16 cases of intrauterine pregnancy,1 case of ectopic pregnancy,1 case of early spontaneous abortion.There was no significant difference in the Intrauterine pregnancy rate,spontaneous abortion rate and ectopic pregnancy rate between the observation group and the control group(P > 0.05).(3)The pregnancy outcome was compared between the observation group and the control group in stage III and IV.The control group included 9 cases of pregnancy,8 cases of intrauterine pregnancy,and 1 case of ectopic pregnancy,including 1 case of early spontaneous abortion.In the observation group,there were 11 cases of pregnancy,11 cases of intrauterine pregnancy,0 cases of ectopic pregnancy,and 1 case of early spontaneous abortion.The Intrauterine pregnancy rate,spontaneous abortion rate and ectopic pregnancy rate in the observation group and the control group were not statistically significant(P> 0.05).(4)Effective pregnancy rates were compared between the two groups at different stages,17 cases of stage I and II total pregnancy,11 cases of stage III and IV pregnancy in the observation group.In the control group,there were 15 cases of stage I and II pregnancy,and 9 cases of stage III and IV pregnancy.There was no significant difference in the total pregnancy rate between different groups of patients with endometriosis(P>0.05).(5)In 6 months,there were 17 cases of pregnancy in the observation group,14 cases in the control group,11 in the 6-12 month observation group and 10 in the control group.There was no significant difference in the pregnancy rate between the observation group and the control group for 6 months and 6-12months(P > 0.05).With the prolongation of time,the pregnancy rate of the two groups was obviously decreased,but the difference was not statistically significant(P > 0.05).(6)The recurrence rate between the control group and the observation group were compared.The observation group recurrence rate was 14.6%,and the control group recurrence rate was 32.7%.The recurrence rate of the observation group was significantly lower than that of the control group,and the difference was statistically significant(P <0.05).There was no significant difference in the recurrence rate of endometriosis between the two groups(P>0.05).Conclusion:Laparoscopic surgery combined with Gn RH-α treatment in patients with endometriosis can effectively reduce the recurrence rate,but can not effectively improve the pregnancy rate. |
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