Effect of GnRHa on Pregnancy Rate in Patients with Stage I-II Endometriosis Associated with Infertility After Laparoscopy Surgery

Objective:To investigate the effect of GnRHa on pregnancy rate in patients with stage Ⅰ-Ⅱendometriosis(EMs) associated with infertility after laparoscopy surgery.Methods:Sixty infertility patients associated with stageⅠ-Ⅱ EMs who were diagnosed and treated by laparoscopy surgery and excluded the other causes of infertility were divided into GnRHa treatment group(n=30,group A)and HMG treatment group(n=30,group B)after surgery according to the willing of the patients.The patients in group A were treated by GnRHa injection three times,fourty days after the last injection the patients were treated by HMG with the dose of 37.5-112.5 IU every day according to the patients′age and the reserve of ovarian function.At the same time,the patients in group B were directly treated by HMG with the dose of 37.5-112.5 IU every day after the surgery.The ovulation induction sycles in both groups were limited to six sycles and all the patients were followed-up for 12 months after surgery or the last GnRHa injection to evaluate the effect of the different treatments on the pregnancy rate of one month、three months、six months and twelve months.and to observe the dysmenorrheal and the serum CA125 levels in patients to evaluate the relapse rates.Results:①In group A,the clinical pregnancy rate was 36.6%(11/30)in one month;the cumulative clinical pregnancy rates were 56.6%(17/30)、66.7%(20/30) and 76.7%(23/30)in three months、six months and twelve months,respectively.In group B,the clinical pregnancy rate was 16.7%(5/30)in one month;the cumulative clinical pregnancy rates were 30%(9/30)、36.7%(11/30) and 50.0%(15/30)in three months、six months and twelve months,respectively.The cumulative clinical pregnancy rates of group A in three months,six months,twelve months were significantly higher than those of group B.②The serum CA125 levels in group A in three and six months after surgery was significantly lower than those in group B,and the dysmenorrheal recurrence rate of group A was significantly lower than that in group B in six and twelve months after laparoscopy surgery.Conclusions:GnRHa treatment after laparoscopy can delay the recurrence of EMs and can improve the pregnancy rate of patients with stage Ⅰ-Ⅱ endometriosis associated with infertility,and the ovulation induction cycles should not beyond six cycles.