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| The influence of GnRHa combined with addback therapy on the levels of serum sex hormones, calcium and phosphate levels, and endometrium of women with endometriosis at stage III and IV |
| General Hospital of Panzhihua Group, Panzhihua, Sichuan Province, 617000 |
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Abstract Objective: To analyze the influence of gonadotropinreleasing hormone agonist (GnRHa) combined with addback therapy on the levels of serum sex hormones, calcium and phosphate, and endometrium of women with endometriosis (EMT) at stage III and IV. Methods: 270 women with EMT at stage III and IV were selected and were randomly divided into group A, B and C (90 cases in each group) from June 2013 to June 2018. Women in group A were treated by GnRHa and addback add tibolone, women in group B were given GnRHa and addback estradiol valerate, and women in group C were given GnRHa only. All women were treated for 3 months. The modified Kupperman index (KMI), perimenopausal symptoms, levels of serum estradiol (E2), folliclestimulating hormone (FSH), luteinizing hormone (LH), calcium, and phosphate, endometrial changes under ultrasound, the incidence of adverse reaction, recurrence rate, and pregnancy rate of women were compared among the three groups. Results: KMI score of women in group A or group B were significant lower than those of women in group C in 1 month or 3 months after treatment (P<0.01). The serum calcium level of women in group A or group B was significant higher than that of women in group C after treatment, while levels of E2, FSH, LH and phosphate were significant lower (P<0.01). The endometrial thickness of all women in the three groups significantly decreased after treatment (P<0.01), but there was no significant difference in endometrial thickness among the three groups (P>0.05). The incidence of adverse reaction of women in group A or group B was 3.3% or 4.4%, which was significant lower than that (13.3%) of women in group C, while the pregnancy rate of women in group A or group B was 50.0% or 51.1%, which was significant higher than that (33.3%) of women in group C (P<0.05). There was no significant difference in the recurrence rate among the three groups (P>0.05). Conclusion: GnRHa combined with addback therapy can effectively relieve perimenopausal symptoms, improve serum levels of sex hormones, calcium and phosphate, reduce the incidence of adverse reaction, and improve pregnancy rate of women with EMT.
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