Postlaparoscopic GnRHagonist Therapy does not Improve Spontaneous Conception Rates of Women with Endometriosis

Kevin Dominique Tjandraprawira, Tono Djuwantono
In: Indonesian Journal of Obstetrics and Gynecology · 2017 · pp. 87 · doi:10.32771/inajog.v5i2.525 · W2776823194
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Postlaparoscopic GnRH-agonist therapy in women with endometriosis did not significantly improve spontaneous conception rates and appeared to delay conception compared to no hormonal treatment.

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This non-randomized prospective analytic study evaluated whether adding post-laparoscopic GnRH-agonist therapy improves spontaneous conception rates in 121 women with endometriosis followed for 12–24 months, with 60 receiving GnRH-agonist after surgery. Overall, 56 women (46.3%) achieved spontaneous conception, but GnRH-agonist therapy did not significantly improve spontaneous pregnancy rates (OR 1.539; 95% CI 0.750–3.159; p=0.239). The study also found that women not receiving hormonal therapy conceived more quickly than those who did (5.91 ± 6.28 vs 8.56 ± 4.24; p=0.011). This paper is centrally about endometriosis — it specifically tests whether post-laparoscopic GnRH-agonist therapy improves spontaneous conception outcomes in women with endometriosis.

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Abstract

Objective: To investigate the reproductive benefits of combining laparoscopic surgery with GnRH-agonist hormonal therapy in treating women with endometriosis. Methods: This is a non-randomized prospective analytic study of patients with endometriosis conducted in a private hospital in Bandung during the period of January 2014 to December 2015, whom were later followed up after 12-24 months for assessment of post-surgical reproductive performance. A total of 121 patients were enrolled, 60 of which received post-surgical GnRH-agonist hormonal therapy. Results: We discovered that 56 women (46.3%) eventually achieved spontaneous conception after surgery but upon further analysis, it was discovered that GnRH-agonist played no significantly meaningful role in improving the spontaneous pregnancy rates of these patients (OR 1.539; 95% CI 0.750-3.159; p-value 0.239). Furthermore, even though there was a wide range as to when they achieved conception, those untreated with hormonal therapy tended to conceive far more quickly than those who were (5.91 ± 6.28; 8.56 ± 4.24; p-value: 0.011). Conclusion: Post-laparoscopic GnRH-agonist administration to women with endometriosis does not significantly improve their chances of spontaneous conception. In fact, such administration seems to delay it. [Indones J Obstet Gynecol 2017; 5-2: 87-93] Keywords: endometriosis, GnRH-agonist, laparoscopy
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Objective

To investigate the reproductive benefits of combining laparoscopic surgery with GnRH-agonist hormonal therapy in treating women with endometriosis.

Methods

This is a non-randomized prospective analytic study of patients with endometriosis conducted in a private hospital in Bandung during the period of January 2014 to December 2015, whom were later followed up after 12-24 months for assessment of post-surgical reproductive performance. A total of 121 patients were enrolled, 60 of which received post-surgical GnRH-agonist hormonal therapy.

Results

We discovered that 56 women (46.3%) eventually achieved spontaneous conception after surgery but upon further analysis, it was discovered that GnRH-agonist played no significantly meaningful role in improving the spontaneous pregnancy rates of these patients (OR 1.539; 95% CI 0.750-3.159; p-value 0.239). Furthermore, even though there was a wide range as to when they achieved conception, those untreated with hormonal therapy tended to conceive far more quickly than those who were (5.91 ± 6.28; 8.56 ± 4.24; p-value: 0.011).

Conclusion

Post-laparoscopic GnRH-agonist administration to women with endometriosis does not significantly improve their chances of spontaneous conception. In fact, such administration seems to delay it. [Indones J Obstet Gynecol 2017; 5-2: 87-93]

Keywords

endometriosis, GnRH-agonist, laparoscopy

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endometriosis

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