OBJECTIVE: To determine the efficacy of laparoscopic surgery combined with GnRH agonist (GnRH-a) in treating infertile patients with endometriosis (EMs), and analyze its effect on the levels of serum hormones and inflammatory factors of the patients. STUDY DESIGN: An experimental study. PLACE AND DURATION OF STUDY: The Department of Urology, Zhongda Hospital, Southeast University, Jiang Su, China, from January 2015 to March 2016. METHODOLOGY:One hundred and thirty infertile patients with EMs were randomly divided into a control group and an observation group with 65 cases in each group. Patients in the control group were treated by laparoscopic surgery, while patients in the observation group were added by the subcutaneous injection of GnRH-a, based on the treatment of the control group. Therapeutic effects, recurrence rates, and pregnancy rates between two groups were compared. Moreover, the levels of serum hormones estradiol (E₂), luteinizing hormone (LH), follicle stimulating hormone (FSH), inflammatory factors interleukin 17 (IL-17), interleukin 6 (IL-6), and tumor necrosis factor- (TNF-α) between two groups after treatment were compared. RESULTS: The total effective rate and pregnancy rate in the observation group were higher than those of the control group (p=0.009 and 0.002, respectively), and the recurrence rate was lower than that of the control group (p=0.008). After treatment, levels of serum E₂, LH, FSH in the observation group were lower than those of the control group (all p<0.001). Levels of serum IL-17, IL-6and TNF-α were lower than those of the control group (all p<0.001). There was no statistically significant difference in adverse reactions between the two groups (p=0.730). CONCLUSION:Laparoscopic surgery combined with GnRH-a is a more effective treatment modality in endometriosis. It can reduce the serum levels of inflammatory factors in patients, improve their hormone level and pregnancy rate, and reduce the recurrence rate.
RCT Entities:
OBJECTIVE: To determine the efficacy of laparoscopic surgery combined with GnRH agonist (GnRH-a) in treating infertilepatients with endometriosis (EMs), and analyze its effect on the levels of serum hormones and inflammatory factors of the patients. STUDY DESIGN: An experimental study. PLACE AND DURATION OF STUDY: The Department of Urology, Zhongda Hospital, Southeast University, Jiang Su, China, from January 2015 to March 2016. METHODOLOGY: One hundred and thirty infertilepatients with EMs were randomly divided into a control group and an observation group with 65 cases in each group. Patients in the control group were treated by laparoscopic surgery, while patients in the observation group were added by the subcutaneous injection of GnRH-a, based on the treatment of the control group. Therapeutic effects, recurrence rates, and pregnancy rates between two groups were compared. Moreover, the levels of serum hormones estradiol (E₂), luteinizing hormone (LH), follicle stimulating hormone (FSH), inflammatory factors interleukin 17 (IL-17), interleukin 6 (IL-6), and tumor necrosis factor- (TNF-α) between two groups after treatment were compared. RESULTS: The total effective rate and pregnancy rate in the observation group were higher than those of the control group (p=0.009 and 0.002, respectively), and the recurrence rate was lower than that of the control group (p=0.008). After treatment, levels of serum E₂, LH, FSH in the observation group were lower than those of the control group (all p<0.001). Levels of serum IL-17, IL-6 and TNF-α were lower than those of the control group (all p<0.001). There was no statistically significant difference in adverse reactions between the two groups (p=0.730). CONCLUSION: Laparoscopic surgery combined with GnRH-a is a more effective treatment modality in endometriosis. It can reduce the serum levels of inflammatory factors in patients, improve their hormone level and pregnancy rate, and reduce the recurrence rate.
Authors: Innie Chen; Veerle B Veth; Abdul J Choudhry; Ally Murji; Andrew Zakhari; Amanda Y Black; Carmina Agarpao; Jacques Wm Maas Journal: Cochrane Database Syst Rev Date: 2020-11-18