INTEGRATED MANAGEMENT OF OVARIAN ENDOMETRIOMAS: PRE- AND POST-SURGICAL USE OF DIENOGEST.

Q4 Medicine
Georgian medical news Pub Date : 2024-10-01
N Grigalashvili, L Pkhaladze, A Khomasuridze
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引用次数: 0

Abstract

Aim: to evaluate the efficacy of an integrated management approach for ovarian endometriomas using Dienogest administered both before and after laparoscopic cyst enucleation in women with infertility.

Materials and methods: The prospective, comparative clinical trial included 44 patients aged 18-35 years with ovarian endometriomas and infertility. Patients were randomly divided into two groups: the study group (20 participants) received Dienogest for six months before and after laparoscopic cyst enucleation, while the control group (24 participants) underwent laparoscopic cyst enucleation without additional hormonal treatment. Outcomes measured included: cyst size (before treatment and after six months of Dienogest administration in the study group), serum levels of anti-Müllerian hormone (AMH), antral follicle count (AFC) in both groups (before and six months after surgery), pregnancy rates, and recurrence rates of endometriomas within a 1-year follow-up.

Results: Study Group: Dienogest treatment resulted in a significant reduction in cyst size before surgery. AFC and AMH levels remained stable before and after surgery. At the 1-year follow-up, 13 participants (65%) achieved pregnancy, and endometrioma recurrence was observed in 3 participants (15%).

Control group: Six months post-surgery, AFC and AMH levels were significantly lower than pre-surgery levels. During the follow-up, 7 participants (29.2%) achieved pregnancy, and endometrioma recurrence was noted in 19 participants (79.2%).

Conclusion: The integrated management approach using Dienogest administered both before and after laparoscopic cyst enucleation has proven to be effective in improving reproductive outcomes and reducing recurrence rates of ovarian endometriomas in women with infertility.

卵巢子宫内膜异位瘤的综合治疗:术前和术后使用地孕激素。
目的:评价不孕症妇女腹腔镜下囊肿摘除前后应用地诺孕素治疗卵巢子宫内膜异位瘤的综合治疗方法的疗效。材料与方法:前瞻性、比较临床试验纳入44例年龄18-35岁的卵巢子宫内膜异位瘤合并不孕症患者。患者随机分为两组:研究组(20人)在腹腔镜囊肿去核前后6个月接受Dienogest,对照组(24人)在不加激素治疗的情况下进行腹腔镜囊肿去核。测量的结果包括:囊肿大小(研究组治疗前和服用Dienogest 6个月后)、两组(手术前和手术后6个月)血清抗勒氏杆菌激素(AMH)水平、窦卵泡计数(AFC)、妊娠率和1年随访期间子宫内膜异位瘤复发率。结果:研究小组:在手术前,孕激素治疗导致囊肿大小显著减小。手术前后AFC和AMH水平保持稳定。在1年的随访中,13名参与者(65%)成功怀孕,3名参与者(15%)子宫内膜瘤复发。对照组:术后6个月AFC、AMH水平明显低于术前。在随访期间,7名参与者(29.2%)成功怀孕,19名参与者(79.2%)子宫内膜瘤复发。结论:腹腔镜下囊肿去核前后联合应用Dienogest可有效改善不孕妇女的生殖结局,降低卵巢子宫内膜异位瘤的复发率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Georgian medical news
Georgian medical news Medicine-Medicine (all)
CiteScore
0.60
自引率
0.00%
发文量
207
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