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| Clinical efficacy of palacelaparoscopy combined with GnRHa for treating endometriosis complicated with infertility and analysis of influencing factors of postoperative pregnancy |
| 1.Zhengzhou Shenma Maternity Hospital, Zhengzhou, Henan, 450000；2.Fifth Affiliated Hospital of Zhengzhou University |
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Abstract Objective: To investigate the clinical efficacy of palacelaparoscopy combined with GnRHa (Gonadotropinreleasing hormone agonist) for treating of endometriosis (EM) complicated with infertility, and to analyze influencing factors of postoperative pregnancy. Methods: 58 cases of EM patients with infertility treated by palacelaparoscopy surgery in Zhengzhou shenma maternity hospital were selected as research objects. 30 cases of patients were treated by GnRHa after operation were in observation group, and 28 cases of patients were treated by gestrinone after operation were in control group. The therapeutic effect and adverse reaction of drugs were compared between the two groups, and factors affecting postoperative pregnant rate of all included patients were analyzed. Results: The rate of symptom relief of patients in observation group was significantly higher than that of patients in control group, and the recurrence rate of patients in observation group was significantly lower than that of patients in control group (P<0.05). The incidence of vaginal bleeding and rate of aminotransferase elevated of patients in observation group were significantly lower than those of patients in control group (P<0.05). There was no significant difference in clinical pregnant rate between the two groups (P>0.05). In observation group, there was no significant difference in the age, the duration of infertility, and the history of pelvic surgery between the postoperative pregnant women and postoperative nonpregnant women (P>0.05). There were significant different in rAFS staging and tubal patency between the two groups (P<005). Multivariate analysis showed that rAFS staging and tubal patency were the key factors that affected the postoperative pregnant rate of observation group. Conclusion: The palacelaparoscopy combined with GnRHa to treat EM complicated with infertility can effectively increase the pregnant rate and reduce the risk of EM recurrence, decrease the adverse reactions, and improve the security. Tubal patency and rAFS staging are the main factors that affecting thepregnant rate of women with EM post operation, so women with EM postoperative should accept related examinations and IVF actively for improving pregnant rate.
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