Meng Xie1, Huan Yu1, Xuyin Zhang2, Wenping Wang3, Yunyun Ren4. 1. Department of Ultrasound, Obstetrics and Gynecology Hospital, Fudan University, 128 Shen yang Road, Shanghai 200090, China. 2. Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, 128 Shen yang Road, Shanghai 200090, China. 3. Department of Ultrasound, Zhongshan Hospital, Fudan University, 111 Yi Xueyuan Road, Shanghai 200032, China. 4. Department of Ultrasound, Obstetrics and Gynecology Hospital, Fudan University, 128 Shen yang Road, Shanghai 200090, China. Electronic address: yunyunren11@163.com.
Abstract
OBJECTIVE: To explore the effects of GnRHa on adenomyosis by transvaginal elastography. METHODS: A prospective observational study included patients who were diagnosed as adenomyosis by conventional transvaginal ultrasound and infertility. The sonographic characters of elastography, the degree of dysmenorrhea and the values of serum CA125 before and following GnRHa (Triptorelin 3.75 mg were administered every 28 days) plus add-back therapy were reviewed and analyzed. Each case had a 6 months follow up and the information of pregnancy were recorded. RESULTS: 45 patients who completed the 6 months follow-up were included in the analysis. Twelve cases (group 1) were pregnancy during the follow-up and the other thirty-three cases (group 2) failed their attempts. The numerical rating scale and CA125 of all the cases were both significantly reduced 6 months after therapy. All of enlarged uterus decreased to accessible normal size. In group 1, the mean elasticity score was significantly higher for the uterine after therapy than before (3.6 ± 0.3 vs 2.3 ± 0.5, p = 0.004). In group 2, the mean elasticity score did not change for the uterine after therapy than before (2.2 ± 0.5 vs 2.5 ± 0.6, p = 0.77). CONCLUSION: Elasticity of adenomyosis is increased after GnRHa therapy. And the higher elasticity of adenomyosis after GnRHa therapy is associated with spontaneous pregnancy in infertile patents.
OBJECTIVE: To explore the effects of GnRHa on adenomyosis by transvaginal elastography. METHODS: A prospective observational study included patients who were diagnosed as adenomyosis by conventional transvaginal ultrasound and infertility. The sonographic characters of elastography, the degree of dysmenorrhea and the values of serum CA125 before and following GnRHa (Triptorelin 3.75 mg were administered every 28 days) plus add-back therapy were reviewed and analyzed. Each case had a 6 months follow up and the information of pregnancy were recorded. RESULTS: 45 patients who completed the 6 months follow-up were included in the analysis. Twelve cases (group 1) were pregnancy during the follow-up and the other thirty-three cases (group 2) failed their attempts. The numerical rating scale and CA125 of all the cases were both significantly reduced 6 months after therapy. All of enlarged uterus decreased to accessible normal size. In group 1, the mean elasticity score was significantly higher for the uterine after therapy than before (3.6 ± 0.3 vs 2.3 ± 0.5, p = 0.004). In group 2, the mean elasticity score did not change for the uterine after therapy than before (2.2 ± 0.5 vs 2.5 ± 0.6, p = 0.77). CONCLUSION: Elasticity of adenomyosis is increased after GnRHa therapy. And the higher elasticity of adenomyosis after GnRHa therapy is associated with spontaneous pregnancy in infertile patents.
Authors: Gaby Moawad; Mira H Kheil; Jean Marc Ayoubi; Jordan S Klebanoff; Sara Rahman; Fady I Sharara Journal: J Assist Reprod Genet Date: 2022-03-28 Impact factor: 3.412