Clinical Analysis Of GnRH-a Following Laparoscopy In The Treatment Of Endometriosis And Infertility

Objective: This study is designed to find the effect of GnRH-a to endometriosis and infertility patients were treated with it after they accepted laparoscopy. At the same time , the curative effect of homemade GnRH-a was compared with the imported.Methods : 71 endometriosis and infertility patients who were treated by the laparoscopy were divided into research group and control group. (1)In research group 43 patients were divided into homemade GnRH-a group (23 cases) and imported GnRH-a group (20 cases) again. The patients of two groups employed drug when the operation had finished in one week. Usage:The two groups were injected by hypodermic. The dose of homemade GnRH-a(Alarelin) group is 150μg. The patients were injected every 28 days and did not used it until three months. The imported GnRH-a(Zoladex) group accepted hypodermic injection in abdomen. The dose of it is 3.6mg and did not used it until three months. Then they were injected one time after 28 days and did not apply GnRH-a until three months. Control group included 28 patients without any drug treatment after laparoscopy。At the same time , the research group took calcium tablet orally.The dose is 300-600mg each day. (2) Control group : The control group included 28 patients without any drug treatment after laparoscopy. The serum reproduction hormone level,liver function and bone density were determined before and after drug therapy. At the same time, the research group were compared with the control group by clinical therapeutic effect,drug side effect,menses and pregnancy .Results:①Serum follicle-stimulating hormone(FSH),luteal hormone(LH)and E2 were obviously decreased after the research groups accepted drug therapy for 3 months(P<0.05). E2 keeped up with menopause. The hormone level of the Alarelin and Zoladex groups were similar before the therapy (P>0.05).②The clinical ache of all patients were alleviated or disappeared after the operation. All curative effect is 84.2%. The research group and the control group were 91.3% and 79.2% respectively. The clinical effect of research group was better than the control group(P<0.05). The Alarelin and Zoladex groups had no difference (P>0.05).③T he patients of research group appeared side effect after they applyed medicine for 40 days. The occurring rate of Alarelin group is 13%(3/23)and the Zoladex group is 10%(2/20). These symptoms were so light that all patients could bear them. When drug was withdrawed for 15～20d, these symptoms relieved or disappeared automatically. The mensuration of BMD of the Alarelin and Zoladex parts had no diffence before the therapy (P>0.05). It declined after the patients applied drug. But it was in the normal range. The diffence of two parts of the research group is not obvious. Medication did not affect the function of liver function or kidney.④menstrual flow: All patients of research group appeared amenorrhea during medication. Menses recovered when therapy finished for 4～12w.⑤pregnancy rate: The pregnancy rate was 45.1%(32/71). There was no obvious difference between the research group and the control group. The pregnancy rate of two parts of the research group was not different when they were compared by clinical stage. Comparing the research group with the control group ofⅠ,Ⅱstage or III stage, the pregnancy rate had no defference(P>0.05), but the pregnancy rate of the IV stage cases had significant difference (P<0.05). Conclusion: GnRH-a can improve ache of patients evidently after laparoscopy when it was applied for 3 months. At the same time, GnRH-a can increase the pregnancy rate of IV stage cases。The therapeutic effect of homemade GnRH-a and the imported GnRH-a is equal。...