Impact of GnRH agonist treatment on recurrence of ovarian endometriomas after conservative laparoscopic surgery

Jee, Byung Chul; Lee, Joong Yeup; Suh, Chang Suk; Kim, Seok Hyun; Choi, Young Min; Moon, Shin Yong

doi:10.1016/j.fertnstert.2007.11.027

« Previous Next »Fertility and Sterility
Volume 91, Issue 1 , Pages 40-45, January 2009

Impact of GnRH agonist treatment on recurrence of ovarian endometriomas after conservative laparoscopic surgery

Byung Chul Jee, M.D.
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, South Korea
Joong Yeup Lee, M.D.
- Hamchoon Women's Clinic, Seoul, South Korea
Chang Suk Suh, M.D.
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, Seoul, South Korea
Seok Hyun Kim, M.D.
- Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, Seoul, South Korea
- Reprint requests: Seok Hyun Kim, M.D., Department of OB/GYN, College of Medicine, Seoul National University, 28 Yeongeon, Chongno, Seoul 110–744, South Korea (FAX: 82-2-762-3599).
Young Min Choi, M.D.
- Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, Seoul, South Korea
Shin Yong Moon, M.D.
- Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, Seoul, South Korea

Received 11 August 2007; received in revised form 12 November 2007; accepted 12 November 2007. published online 31 March 2008.

Objective

To analyze the influence of postoperative GnRH agonist treatment on disease recurrence after conservative laparoscopic surgery for ovarian endometriomas according to duration of the treatment.

Design

Retrospective cohort study.

Setting

University hospital.

Patient(s)

One hundred nine consecutive premenopausal women who underwent conservative laparoscopic surgery for ovarian endometriomas (endometriosis stage III/IV) were enrolled in the study. The patients were divided into four treatment groups: expectant management (n = 37) and GnRH agonist therapy for 3 (n = 28), 4 (n = 21), and 6 months (n = 23).

Intervention(s)

None.

Main Outcome Measure(s)

An ultrasound confirmed recurrence of ovarian endometriomas.

Result(s)

The overall crude recurrence rate was 16.5% after follow-up for an average of 20.1 months. The crude recurrence and the cumulative probabilities of disease recurrence at 24/36 months tended to be lower in patients who received a GnRH agonist for 6 months (4.3%, 5.3%/5.3%) compared with those who received it for 3 months (17.9%, 12.5%/25.0%) and 4 months (28.6%, 18.9%/39.2%) and patients with expectant management (16.2%, 22.4%/37.9%). However, the differences did not reach statistical significance.

Conclusion(s)

Treatment with GnRH agonist for six months had a beneficial impact on the recurrence rate after conservative laparoscopic surgery for ovarian endometriomas.

Key Words: Endometriosis, endometrioma, recurrence, gonadotropin-releasing hormone agonist