Effect of gonadotropin-releasing hormone agonist used before surgery on natural pregnancy rates in patients with ovarian endometriomas / 中华妇产科杂志

ABSTRACT

Objective To evaluate the impact of gonadotropin-releasing hormone agonist(GnRH-a) used before surgery on natural pregnancy rates in patients with ovarian endometriomas. Methods In this retrospective study, 57 patients with ovarian endometriomas who had a consecutive laparoscopic surgery between June, 2010 to September, 2015 in Peking Union Medical College Hospital were included. Those patients were divided into preoperative GnRH-a treatment group(n=31)and non-GnRH-a treatment group (n=26). There were no differences in patients'characteristics between the two groups. All of them had a desire for natural pregnancy postoperatively. GnRH-a was no longer used after surgery. After the surgical procedure, the patients were observed over a period of 12 months, during which the frequency of natural pregnancy was assessed. The two groups were compared in terms of natural pregnancy rates. Results Totally 33 patients had natural pregnancy after surgery. The univariate analysis showed that the pregnancy rates of age, r-AFS stage, infertility, preoperative use of GnRH-a, tumor size, tumor side, deep infiltrating endometriosis and adenomyosis did not have statistically significant differences (all P>0.05). The two classified logistic regression showed that OR for preoperative use of GnRH-a was 0.250(95％CI 0.064-0.978)with a statistical difference(P=0.046). Conclusion The use of GnRH-a preoperatively may have a negative effect on natural pregnancy rates of patients after surgery with ovarian endometriomas.