Gonadotrophin-Releasing Hormone Analogue Treatment for Endometriosis Following Conservative Surgery:A Meta-analysis

Objective:To evaluate the effectiveness and side effect of gonadotrophin-releasing hormone analogue(GnRH-a)in the treatment of endometriosis following conservative surgery.Methods:We searched the following databases from their inception to Mar.2009:the Cochrane Library,PubMed,Embase,SCI,Chinese Biomedicine Database,Google Scholar,reference lists of articles and relevant publications.Selection criteria:Randomized controlled trials(RCTs)that compared postoperative GnRH-a treatment with no treatment,placebo or progestins for endometriosis was selected.Data collection and analysis:Two reviewers independently extracted the data and analyzed them by Meta-analysis in the RevMan 5.0 software.Results:Eighteen RCTs including 1716 patients were included.There was a significantly higher rate of total remission of disease in GnRH-a compared with control group.Postoperative GnRH-a treatment could not increase the pregnancy rate of infertility associated with endometriosis.Despite the 1 year recurrence of painful symptom was statistically lowr,there was no difference in 2 and 5 year recurrence.There was no statistical difference between GnRH-a and progestins group on all outcome measures.Conclusions:Postoperative using GnRH-a for endometriosis can effectively reduce the recurrence of pain within 1 year and improve the total remission rate of diseases,which has no advantage on pregnancy rate,recurrence of disease and painful symptoms in 2 year later.And it is no benefit on pregnancy rate,remission of chronic pelvic pain and recurrence of painful symptoms compared with progestins.