[Effect of gonadotropin-releasing hormone agonist on fertility potential in patients with stage I endometriosis after laparoscopy]

Abstract

Objective: To investigate the impact on fertility potential of patients with stage I endometriosis treated by gonadotropin-releasing hormone agonist (GnRH-a) treatment followed by laparoscopy surgery.

Methods: From Jan. 2006 to Jun. 2008, medical documents of 102 patients with minimal or mild endometriosis (stage I) treated by laparoscopy and hysteroscopy surgery and excluded the other causes of infertility were reviewed retrospectively in Peking University People's Hospital. The pelvic endometriosis lesions were destroyed by electric burning. Those patients were divided into GnRH-a treatment group (n=60) and non-GnRH-a treatment group (n=42) after surgery. The patients in GnRH-a treatment group were administered by GnRH-a injection once or twice after surgery, in the mean time, no adjuvant therapy were given for the patients in the other group. All the patients were followed-up for 24 months after surgery to evaluate the effect of postoperative GnRH-a treatment on pregnancy outcome and fertility potential (number of pregnancy per 100 women in one month, expressed as percentage).

Results: The total pregnancy rate of 78% (47/60) in GnRH-a treatment group is significantly higher than 55% (23/42) in non-GnRH-a treatment group (P=0.012). There is no significant difference in spontaneous abortion rate between the GnRH-a treatment group and non GnRH-a treatment group (19% vs. 13%, P=0.465). The fecundity rate of were 6.17% in GnRH-a treatment group and 3.26% in non-GnRH-a treatment group, which the relative risk is 1.9 (95%CI: 1.1-3.0).

Conclusion: Low-dose GnRH-a treatment after laparoscopy can improve the pregnancy rate and fertility potential of patients with stage I endometriosis.