ABSTRACT
El objetivo de la investigación fue determinar la utilidad del tratamiento con goserelina en la tasa de embarazos en pacientes con infertilidad debida a endometriosis leve-moderada. Se realizó un estudio prospectivo, en el que se incluyó a 76 mujeres con diagnóstico de infertilidad y endometriosis leve-moderada que asistieron al Hospital Central Dr. Urquinaona. El grupo de estudio (grupo A; n = 42 pacientes) que fueron tratadas con goserelina de depósito por vía subcutánea, una vez al mes por 3 meses. Al reiniciar los ciclos menstruales, se realizó hiperestimulación ovárica controlada / inseminación intrauterina. En el grupo de control (grupo B; n = 34 pacientes) solo se realizó hiperestimulación ovárica controlada / inseminación intrauterina. Se analizó la tasa de embarazos. La tasa de embarazos en el grupo A fue de 35,7 % por paciente y 24,5 % por ciclo estimulado. En el grupo B, la tasa fue de 32,3 % por paciente y del 23,9 % por ciclo estimulado. La tasa en el grupo de pacientes tratadas con goserelina fue más alta en el grupo de pacientes no tratadas, pero estas diferencias no son estadísticamente significativas (p = ns). Se concluye que el tratamiento con goserelina por 3 meses no es útil en pacientes con infertilidad debida a endometriosis leve-moderada, ya que no produce un aumento significativo en la tasa de embarazos.
The objective of research was to determine the usefulness of goserelin in the pregnancy rate in patients with infertility due mild - moderate endometriosis. A prospective study was conducted in which 76 women with a diagnosis of infertility and mild-moderate endometriosis was included, who attended the Central Hospital Dr. Urquinaona. The study group (group A; n = 42 patients) were treated with goserelin depot subcutaneously once monthly for 3 months. Upon restarting menstrual cycles, controlled ovarian hyperstimulation / intrauterine insemination was performed. In the control group (group B, n = 34 patients), only controlled ovarian hyperstimulation / intrauterine insemination was performed. The pregnancy rate was analyzed. The pregnancy rate in group A was 35,7 % per patient and 24,5 % per stimulated cycle. In group B, the rate was 32,3 % per patient and 23,9 % per stimulated cycle. The rates in the group of patients treated with goserelin were higher in the group of untreated patients, but these differences were not statistically significant (p = ns). It is concluded that treatment with goserelin for 3 months is not useful in patients with infertility due mild - moderate endometriosis, as it does not produce a significant increase in the rate of pregnancy.
Subject(s)
Humans , Female , Pregnancy , Ovarian Hyperstimulation Syndrome , Goserelin , Endometriosis , Infertility, Female , Venezuela , InseminationABSTRACT
Objective To investigate the expression of RhoA and Rho kinase in junctional zone (JZ) of adenomyosis and normal myometrium and explore its relationship with severity of dysmenorrheal.Methods From Mar.to Dec.2012,32 cases with adenomyosis undergoing hysterectomy were enrolled as adenomyosis group including 18 cases with proliferative endometrium and 14 cases with secretory endometrium matched with 29 cases with hysterectomy due to cervical disease and ovarian tumor as control group including 12 cases with proliferative endometrium and 17 cases with secretory endometrium in Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University.JZ smooth muscle cells were isolated and cultured immediately after the operation.The expression of mRNA and protein of RhoA and ROCK Ⅰ in JZ in two groups were measured by real-time fluorescence quantitative RT-PCR and western blot.Results (1) The mRNA expression of RhoA and ROCK Ⅰ in JZ of adenomyosis group did not show cyclic change.In proliferative phase,the expression of RhoA and ROCK Ⅰ (1.41 ±0.16,1.05 ±0.15) was not significantly higher than that in secretory phase (1.17 ± 0.25,0.98 ± 0.10) (P ＞ 0.05).While JZ in control group,it showed obviously cyclic change.The expression level of them in proliferative phase(0.93 ±0.10,1.00 ± 0.18) was significantly higher than that in secretory phase (0.48 ± 0.03,0.55 ± 0.05) (P ＜0.05) ; It also showed that expressions of RhoA and ROCK Ⅰ in adenomysis group were significant higher than those in the control (P ＜ 0.05).(2) The mRNA and protein expression of RhoA and ROCK Ⅰ was positively correlated in each of two groups (r =0.48,P ＜ 0.01 ; r =0.67,P ＜ 0.01).(3) The expression of RhoA and ROCK Ⅰ were 1.66 ±0.19,1.32 ±0.11 in severe dysmenorrheal,1.28 ±0.12,1.09 ±0.08 in moderate dysmenorrheal and 0.93 ± 0.09,0.81 ± 0.06 in mild dysmenorrheal,it all reached statistical difference when compared the other group.(All P ＜ 0.05).Conclusions The expressions of RhoA and ROCK Ⅰ in JZ in adenomyosis group were higher than those in control group,and positively correlated with the severity of dysmenorrheal in adenomysis group,but it does not change with the menstrual cycle.High expression of RhoA and ROCK Ⅰ might be involved in abnormal contraction of uterine myometrium and correlated with the dysmenorrheal in adenomysis.