Yang Xin-Hua, Ji Fei, AiLi AiXingZi, TuerXun HaNiKeXi, He Yan, Ding Yan
Clin Exp Obstet Gynecol. 2014;41(3):272-5.
The aim of this study was to investigate the impacts of laparoscopic ovarian endometriosis cystectomy combined with postoperative GnRH-a therapy on ovarian reserve, pregnancy outcome and recurrence.
This was a prospective control study. The experimental group: 63 patients with combinations of laparoscopic bilateral ovarian endometrial cystectomies and gonadotropin-releasing hormone agonist (GnRH-a) treatment for three months.
62 patients with laparoscopic bilateral ovarian endometrial cystectomies. Benchmarks: the changes of follicle stimulating hormone (FSH) and FSH/luteinizing hormone (LH), etradiol (E2) in preoperative and postoperative three months or menstrual two to three days, menstrual two to three days after surgery, natural pregnancy, and cyst recurrence in 18th month during postoperative follow-up.
In experimental group after six months, the percentage of returned FSH accounted for 95.3% of normal range, in the control group it was 82.2%, and the difference was significant (p < 0.05). The natural pregnancy rate of preoperative infertility patients (57.1%) was higher than the control (36.8%) (p < 0.05). The recurrence rate of preoperative infertility patients (12.7%) was lower than the control (27.4%) (p < 0.05).
After bilateral laparoscopic ovarian endometrial cystectomy, an implement of GnRH-a therapy can improve the postoperative pregnancy rate, which changes with clinical stage and patient age, reduces ovarian recurrence, and its influence on ovarian reserve is lesser.
本研究旨在探讨腹腔镜卵巢子宫内膜异位囊肿切除术联合术后GnRH - a治疗对卵巢储备功能、妊娠结局及复发的影响。
这是一项前瞻性对照研究。实验组:63例患者接受腹腔镜双侧卵巢子宫内膜囊肿切除术并联合促性腺激素释放激素激动剂(GnRH - a)治疗三个月。
62例患者接受腹腔镜双侧卵巢子宫内膜囊肿切除术。观察指标:术前及术后三个月或月经周期第2 - 3天、术后月经周期第2 - 3天的促卵泡生成素(FSH)、FSH/黄体生成素(LH)、雌二醇(E2)的变化,自然妊娠情况,以及术后随访第18个月时囊肿复发情况。
术后6个月,实验组FSH恢复至正常范围的比例为95.3%,对照组为82.2%,差异有统计学意义(p < 0.05)。术前不孕患者的自然妊娠率(57.1%)高于对照组(36.8%)(p < 0.05)。术前不孕患者的复发率(12.7%)低于对照组(27.4%)(p < 0.05)。
腹腔镜双侧卵巢子宫内膜囊肿切除术后,实施GnRH - a治疗可提高术后妊娠率,其随临床分期和患者年龄而变化,降低卵巢复发率,且对卵巢储备功能的影响较小。