RESUMEN
Objective To compare the clinical effects of dydrogesterone and gestrinone on postoperative endometriosis and the rate of pregnancy in patients with infertility. Methods One hundred and fifty patients with postoperative endometriosis were enrolled in the current study who were hospitalized in fuzhou General Hospital of Nanjing Command from Jan. 2009 to Aug. 2013. They were randomly divided into dydrogesternne group(76 cases)and gestrenone groups(54 cases)based on progestogent treatment. The situation of pain symptoms improvement,the recurrence rate of 1 year,side effects and postoperative pregnancy rate were observed in order to evaluate the drug efficacy. Results There were a high rate of postoperative pain remission rate and a low recurrence rate of the two groups,and the difference was not significant( P ﹥0. 05 ). The main adverse reaction of patients in dydrogesterone group was breast pain and the incidence rate was 3. 9%( 3/76 ),while there was no breast pain in gestrinone group,and the difference was not significant( P =0. 140 ). The main adverse reaction of patients in gestrinone group was liver function damage and the incidence rate was 25. 9%(7/54),while the dydrogesterone group hadn't liver function damage,and the difference between two groups was significant( P =0. 000 ). The abnormal uterus bleeding incidence rate in dydrogesterone group was 15. 8%(12/76),higher than that of gestrinone group(13. 0%(7/54)),and the difference was significant(P=0. 038) . The serum carbohydrate antigen-125(CA-125)level in two groups were down to normal after operation,and still declined after drug treatment for 3 months. But there was no obvious change after 6 months. One year pregnancy rate of dydrogesterone pregnancy was 80%(24/30),higher than that of gestrinone group(48%,12/25),and the difference was significant( P =0. 038 ). Conclusion There is no significant difference in therapeutic effect between two groups. However,dydrogesterone therapy have no significant liver damage,and a higher postoperation pregnancy rate.
RESUMEN
Objective To study the value of hysteroscopy in the diagnosis and treatment of infertility caused by intrauterine lesions. Methods Hysteroscopic examinations and operations were performed in 82 cases of infertility caused by intrauterine lesions. Results No abnormal findings were found in 4 cases,while the other 78 cases of intrauterine abnormity comprised 23 cases of endometrial polyp, 29 cases of adhesive uteritis,18 cases of submucous myoma or adenomyosis, and 6 cases of uterine deformity. After hysteroscopic surgery and related treatment, the postoperative pregnancy rate reached 62 32% (43 of 69). Conclusions Hysteroscopy may be effectively used in the diagnosis and treatment of infertility caused by intrauterine factors.