Can postoperative GnRH agonist treatment prevent endometriosis recurrence? A meta-analysis

Purpose To investigate whether postoperative GnRH agonist (GnRH-a) treatment can prevent endometriosis recurrence.

This meta-analysis searched PubMed, Embase and Cochrane Library for relevant studies published online before June 2015. Seven randomized controlled trials including 328 patients with postoperative GnRH-a treatment and 394 patients in control group were included in the meta-analysis. In the meta-analysis, the recurrence rate of GnRH-a group compared with control group was evaluated with odds ratio (OR) and its 95 % confidence interval (CI). Heterogeneity, small study effect and publication bias were, respectively, assessed using Higgins I 2, sensitivity analysis and funnel plot.

Postoperative GnRH-a treatment for endometriosis (pooled OR = 0.71; 95 % CI 0.52–0.96) was superior to expectant or placebo treatment in prevention of the recurrence. The recurrence rate decreased significantly in patients who received 6 months GnRH-a treatment (pooled OR = 0.59, 95 % CI 0.38–0.90), whereas no significant difference of recurrence rate existed between patients with 3 months post-surgical GnRH-a therapy and the control group (pooled OR = 0.87, 95 % CI 0.56–1.34). No significant heterogeneity and small study effect were found in the meta-analysis. However, publication bias did existed in the present meta-analysis.

Longer-term (6 months) postoperative administration of GnRH-a can decrease the recurrence risk of endometriosis, whereas 3 months duration of GnRH-a therapy makes no significant difference in preventing the recurrence of endometriosis. Therefore, instead of a 3 month therapy, the duration of the postoperative administration should be longer enough (6 months) to prevent the recurrence of endometriosis. Similar content being viewed by others

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Conflict of interest The authors declare that they have no conflict of interest. Additional information Q. Zheng and H. Mao contributed equally. Electronic supplementary material Below is the link to the electronic supplementary material. Rights and permissions About this article Cite this article Zheng, Q., Mao, H., Xu, Y. et al. Can postoperative GnRH agonist treatment prevent endometriosis recurrence? A meta-analysis. Arch Gynecol Obstet 294, 201–207 (2016). https://doi.org/10.1007/s00404-016-4085-y Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s00404-016-4085-y