Effect Of Gonadotropin Releasing Hormone Analogue Used Before Surgery On Natural Fertility In Patients With Ovarian Endometriomas

[Objectives]To evaluate the natural fertility after Laparoscopic ovarian cystectomy in patients with ovarian endometriomas and analyze the factors of natural fertility;To evaluate the impact of gonadotropin releasing hormone analogue(GnRH-a)used before surgery on natural pregnancy rates in patients with ovarian endometriomas.[Methods]A retrospective study was performed on 123 patients who underwent laparoscopic surgery and were diagnosed with ovarian endometriosis cyst by histopathology at the Department of Obstetrics and Gynecology,Wuxi Maternal and Child Health Hospital,between January 2014 and October 2016.In order to analyze the relationship natural fertility;with clinical factors,including age of the patient,r-AFS stage,infertility,preoperative use of GnRH-a,tumor size,tumor side,deep infiltrating endometriosis and adenomyosis,by comparing the the operation group(56 cases)and the preoperative GnRH-a group(67 cases).?2 tests was used to compare the different frequencies of factors in two groups,then those factors with the natural pregnancy rates were processed into binary logistic regression analysis.[Results](1)During the 12 months follow-up,Totally 70 cases had natural pregnancy,including 39 cases in the operation group(1 case of early pregnancy abortion,38 cases of full-term labor).In the preoperative GnRH-a group,there were 31 cases(3 cases of early pregnancy abortion and 28 cases of full-term labor).(2)The univariate analysis showed that the pregnancy rates of age,r-AFS stage,infertility,tumor size,tumor side,deep infiltrating endometriosis and adenomyosis did not have statistically significant differences(p value all P>0.05).The rate of postoperative natural pregnancy was significantly higher in patients receiving surgery alone(70%,39/56)than in patients receiving GnRH-a before surgery(46%,31/67),but the difference was not statistically significant(P=0.12).The two classified logistic regression showed that OR for preoperative use of GnRH-a was 0.260(95%CI:0.065-0.988),with a statistical difference(P=0.04).[Conclusions]The use of GnRH-a preoperatively may have anegative effect on natural fertility of patients after surgery with ovarian endometriomas.