Gnrh Agonist Treatment On Endometriosis-Associated Infertility After Conservative Surgery:a Systematic Review

Objective:To evaluate the effectiveness of postoperative GnRH agonist in patient with endometriosis-associated infertility.Methods:The Cochrane systematic review method was used to evaluate the Randomized Controlled Trials (RCTs) of GnRH agonist in postoperative medical therapy for endometriosis-associated infertility. The searching strategy included:Pubmed,Embase,CBMdisc,CNKI and VIP,WANFANG Database. Relevant journals were also hand searched. The search was conducted in December2011. Languages was restricted to Chinese and English. Two reviewers independently extracted the data and analyzed them in Revman Manager5.1software.Results:Thirteen RCTs including1322patients were included. In GnRH-a compared with control group, there was a significantly higher rate of pregnancy of â…¢-â…£ endometriosis-associated infertility,[at â… -â…¡ subgroup:OR=1.08,95%CI (0.71,1.64);at â…¢-â…£ subgroup:OR=2.44,95%CI(1.69,3.52)]. There was a significantly higher rate of pregnancy within one year of treatment [at1year subgroup:OR=1.97,95%CI(1.45,2.68);at2-3years subgroup:OR=0.74, 95%CI(0.39,1.40)]. Postoperative GnRH agonist for endometriosis-associated infertility can reduce recurrence rate [OR=0.44,95%CI(0.25,0.79)]. In GnRH-a compared with gestrinone group, there was a significantly higher rate of pregnancy [OR=1.93,95%CI (1.33,2.81)]and lower rate of recurrence [OR=0.44,95%CI (0.23,0.84)].Conclusions:Postoperative GnRH agonist for â…¢-â…£ endometriosis-associated infertility can improve pregnancy rate. Postoperative GnRH agonist for endometriosis-associated infertility can improve pregnancy rate within one year of treatment. Postoperative GnRH agonist for endometriosis-associated infertility can reduce recurrence rate. Compared with gestrinone, there was a significantly higher rate of pregnancy and lower rate of recurrence.