评估长期 GnRH 激动剂疗法对子宫内膜异位症相关种植失败和妊娠损失患者妊娠结局的影响

Masato Kobanawa
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引用次数: 0

摘要

本研究旨在探讨长期促性腺激素释放激素(GnRH)激动剂治疗在预防子宫内膜异位症进展和缓解症状方面的疗效,尤其是对子宫内膜异位症患者在解冻胚胎移植过程中的妊娠结局的影响。我们对临床子宫内膜异位症和复发性着床失败或复发性妊娠失败患者的临床结果进行了比较分析,结果显示,长期接受 GnRH 激动剂治疗以缓解症状(如痛经),然后使用激素替代疗法(HRT)周期进行胚胎移植的患者,与未接受 GnRH 激动剂治疗而使用激素替代疗法周期进行胚胎移植的患者,两者的临床结果存在差异。研究考察了两组患者的各种临床结果。主要结果包括活产率(LBR)、流产率、生化妊娠率和围产期并发症。GnRH激动剂组的活产率明显高于对照组(37.50% vs. 13.04%; p=0.02)。经年龄和孕酮调整的多变量逻辑回归分析显示,GnRH 激动剂组的 LBR 明显高于对照组(几率比:15.3;95% 置信区间:2.30, 102.00;P=0.005)。该研究结果表明,在胚胎移植方案中使用 GnRH 激动剂对反复植入失败或反复妊娠失败的子宫内膜异位症患者有效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluating the Impact of Long-Term GnRH Agonist Therapy on Pregnancy Outcomes in Endometriosis-Associated Implantation Failure and Pregnancy Loss
This study aimed to investigate the efficacy of long-term gonadotropin-releasing hormone (GnRH) agonist therapy in preventing endometriosis progression and relieving symptoms, particularly on pregnancy outcomes during thawed embryo transfer in patients experiencing endometriosis and recurrent implantation failure or recurrent pregnancy loss. In individuals with clinical endometriosis and a history of recurrent implantation failure or recurrent pregnancy loss, we conducted a comparative analysis of clinical outcomes between those undergoing long-term GnRH agonist treatment for symptom relief, such as menstrual pain, followed by embryo transfer using Hormone Replacement Therapy (HRT) cycle, and those undergoing embryo transfer using an HRT cycle without GnRH agonist treatment. The study examined various clinical outcomes between the two groups. The primary outcomes included live birth rate (LBR), miscarriage rate, biochemical pregnancy rate, and perinatal complications. The GnRH agonist group showed significantly higher LBR than the control group (37.50% vs. 13.04%; p=0.02). Multivariable logistic regression analysis, adjusted for age and gravidity, showed significantly higher LBR in the GnRH agonist group compared to the control group (odds ratio: 15.3; 95% confidence interval: 2.30, 102.00; p=0.005). The findings of this study suggested that employing a GnRH agonist in the embryo transfer protocol is effective for patients with endometriosis experiencing recurrent implantation failure or recurrent pregnancy loss.
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