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| The influence of GnRHa combined with laparoscopic for conservative treating infertility women with endometriosis on the pregnancy outcomes |
| 1.Tianjin Ninghe District Hospital, Tianjin,301500；2.Hexi District Liulin Hospital of Tianjin |
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Abstract Objective: To investigate the influence of GnRHa combined with laparoscopic for conservative treating infertility women with endometriosis (EMT) on the pregnancy outcomes. Methods: The data of 228 infertility women with EMT from July 2013 to July 2017were retrospective analyzed. According to different treatment schemes, the women in the observation group (114 cases) were treated by laparoscopic conservative therapy combined with GnRHa, while the women in the control group (114 cases) were only treated by laparoscopic conservative therapy. r-AFS staging was performed for all included women. The serum levels of carcinoembryonic antigen 125 (CA125) of all women were monitored before and 1, 3, 6, 12 month after operation. After followed up for 36 months, the pregnancy rate and pregnancy outcomes of women were recorded. Results: The rates of stage Ⅲ and Ⅳ r-AFS, pregnancy rate, and term delivery rate of women in the observation group were higher than those of women in the control group, and the abortion rate was lower, but there were no significant different between the two groups (P>0.05). There were no significant difference in the rates of ectopic pregnancy and preterm birth, and mode of delivery between the two groups (P>0.05). After operation, the level of CA125 of all women had decreased significantly (P<0.05), and that of women in the observation group was significant lower than that of women in the control group at 1, 3, and 6 months after operation (P<0.05). The recurrence rate of EMT was 4.4% of women in the observation group, which had no significant different from that (7.9%) of women in the control group (P>0.05). Conclusion: Conservative laparoscopic therapy combined with GnRHa can improve the success pregnancy rate of infertility women with moderate and severe EMT, and 6-12 months after treatment is a critical period for pregnancy, which is helpful to optimize the quality of follicles and embryos, and to improve the pregnancy outcomes by improving pelvic environment and ovarian function.
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