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| Effects of laparoscopic surgery combined with gonadotropin releasing hormone agonist for treating infertility patients with endometriosis on their autoimmunity and ovarian functions |
| Haikou Maternity and Child Health Care Hospital, Hainan Province, 570203 |
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Abstract To explore the effects of laparoscopic surgery combined with gonadotropin releasing hormone agonist (GnRH-α) for treating infertility patients with endometriosis (EM) on the levels of their serum AsAb, AEMab, AZpAb, and their ovarian function. Methods：In this prospective research, the infertility patients with EM were enrolled and were divided into observation group (62 cases) and control group (60 cases) by the wishes of the patients from September 2015 to September 2018. The patients in the control group were treated by laparoscopic surgery combined with progesterone therapy, while the patients in the observation group were treated by laparoscopic surgery combined with GnRH-α. In the 3rd or 6th month after surgery, the pain situations of the patients in the two groups were evaluated by visual analogous scale (VAS). The levels of serum autoimmune antibodies, such as AsAb, AEMab, AZpAb, and the ovarian function indexes levels, such as stradiol (E2), luteinizing hormone (LH), and follicle stimulating hormone (FSH), of the patients in the two groups were detected. The situations of pregnancy and recurrence of EM of the patients in the two groups were followed up. Results：In the 3rd or 6th month after surgery, the VAS score and the serum FSH, LH and E2 levels of the patients in the observation group were significantly lower than those of the patients in the control group, and the positive rates of serum AsAb (8.1%), AEmAb (6.5%), and AZpAb (6.5%) of the patients in the observation group were significantly lower than those (21.0%, 17.7%, and 17.7%) of the patients in the control group. The cumulative pregnancy rate of the patients in the observation group in the 12th month (50.0%) and the 24th month (67.7%) after surgery were significantly higher than those (30.0% and 46.7%) of the patients in the control group (all P<0.05), but there was no significant difference in the recurrence rate of the patients between the two groups (P>0.05). Conclusion：Laparoscopic surgery combined with GnRH-αfor treating infertility patients with EM can increase their pregnancy rate and reduce the recurrence of EM after surgery, and the mechanism of which may be related to the immunosuppressive effect of GnRH-αand to the regulation effect of sex hormone.
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