Efficacy of GnRH-a in combination with dienogest therapy in endometriosis and its effects in recurrence and pregnancy status
Abstract
Background
Endometriosis (EMT) is a common gynecologic and hormone-dependent disease that seriously affects patients' quality of life and currently faces certain challenges in clinical treatment.
Objective
To observe the clinical efficacy of gonadotropin-releasing hormone agonists (GnRH-a) in combination with Dienogest treatment in EMT and its effects on recurrence and pregnancy.
Methods
In a retrospective study, 254 patients with EMT from The First Affiliated Hospital, College of Medicine, Zhejiang University were selected between October 2020 and December 2021, and were divided into DT group (Dienogest treatment group) and GD group (GnRH-a combined with dienogest treatment group) according to the treatment modality, both groups were treated with Dienogest, and the GD group was additionally treated with GnRH-a. The primary assessment of both groups was clinical efficacy, recurrence rate and pregnancy (cumulative pregnancy rate, live birth rate, miscarriage rate, multiple pregnancy rate, and ectopic pregnancy rate). Secondary outcomes included the antibody indicator positive rate (anti-endometrial antibodies [AEmAb], anti-sperm antibodies [AsAb], and anti-zona pellucida antibodies [AZpAb]), sex hormone levels (luteinizing hormone [LH], follicle-stimulating hormone [FSH], and estradiol [E2]), serum inflammatory indicator levels (Interleukin-6 [IL-6], C-reactive protein [CRP], tumor necrosis factor-α [TNF-α]), visual analog scale (VAS) scores, and adverse reactions.
Results
After treatment, all indicators improved in both groups (P < 0.05). The clinical efficacy, cumulative pregnancy rate, and live birth rate of patients in the GD group were markedly higher than those in the DT group (P < 0.05). The recurrence rate, positive rate of antibody indicator, sex hormone level, serum inflammation indicator, VAS score, and incidence of adverse reactions of patients in the GD group were remarkably below the DT group (P < 0.05). No marked discrepancies were found in the rates of miscarriage, multiple pregnancy, and ectopic pregnancy in both groups (P > 0.05).
Conclusion
The efficacy of GnRH-a combined with Dienogest in the treatment of EMT is remarkable, which can effectively reduce the inflammatory response, sex hormone levels, and recurrence rate, and markedly improve pregnancy, which is worth promoting its use in the clinic.
© 2026 Ke Zhou, Rong Zhu, Yue Jin, published by Chulalongkorn University
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