Clinical Study of Individualized Treatment of Triptorelin in Endometriosis

Objective: To study the necessarity of individualized treatment of Triptorelin (trade name Diphereline) in the patients with endometriosis. Methods: A prospective clinical study involving 31 patients who underwent chocolate cystectomy. These patients were administered Triptorelin 3.75 mg for 3 to 6 times, 28 days apart. We evaluated the symptoms of genital bleeding and hot flashes during Triptorelin treatment, as well as the levels of serum FSH, LH and estradiol at the first and third weekend after the start of treatment. Results: We divided all the patients into 2 groups according to the genital bleeding(i.e. the group of menstruation-like bleeding and the group of abnormal genital bleeding). Statistically difference of estradiol was found in the first weekend after the treatment between the 2 groups(Z=2.612, P=0.009). The estradiol was positively correlated to the days of genital bleeding (rs=0.587, P0.05). According to the severe hot flashes we divided the patients into 2 groups and found that the serum FSH and FSH/LH ratio was statistically difference in the 3 weekend after treatment(Z=2.247, P=0.025; Z=2.201, P=0.028). The serum FSH and FSH/LH ratio were inversely correlated to the degree of hot flashes(rs=-0.541, rs=-0.588, P0.05). Conclusions: These differences in the endocrinological changes in response to Triptorelin might be derived from the patient′s individual difference. The estradiol at the first weekend after the start of Triptorelin treatment can predict the abnormal genital bleeding. The serum FSH and FSH/LH ratio at the third weekend after the start of Triptorelin treatment can predict the degree of hot flashes and help us to choice the best treatment plan.