Efficacy of GnRH-a in combination with dienogest therapy in endometriosis and its effects in recurrence and pregnancy status

Parameter	DT group (n = 127)	GD group (n = 127)	t/x²	P	Effect size
Age (years)	33.13 ± 7.46	34.78 ± 8.53	1.641	0.102	−0.206
Infertility time (years)	24.59 ± 8.58	24.51 ± 8.43	−0.075	0.940	0.009
Height (years)	159.60 ± 5.20	158.67 ± 5.15	−1.432	0.153	0.180
Weight (kg)	64.75 ± 7.72	64.33 ± 7.06	−0.452	0.651	0.057
Body mass index (kg/m²)	23.42 ± 2.95	22.99 ± 2.52	−1.249	0.213	0.157
Ovarian cysts (single/double)	89/38	83/44	0.648	0.421
Smoking (yes/no)	10/117	9/118	0.057	0.811
Alcohol consumption (yes/no)	15/112	13/114	0.161	0.689
Hypertension (yes/no)	23/104	25/102	0.103	0.749
Diabetes (yes/no)	26/101	27/100	0.024	0.877
Autoimmune disease (yes/no)	5/122	4/123	0.115	0.734
Uterine fibroid tumor (yes/no)	40/87	38/89	0.074	0.786
Cesarean section (yes/no)	48/79	46/81	0.068	0.795
History of gynecologic surgery (yes/no)	10/117	11/116	0.052	0.820
Temperature (°C)	36.37 ± 0.29	36.42 ± 0.30	1.350	0.178	0.169
Breathing (breaths/min)	17.05 ± 1.80	17.12 ± 1.85	0.306	0.760	−0.038
Heart rate (beat/min)	75.34 ± 7.15	74.79 ± 7.17	−0.612	0.541	0.077
Systolic blood pressure (mmHg)	119.52 ± 6.25	119.26 ± 6.14	−0.334	0.738	0.042
Diastolic blood pressure (mmHg)	75.91 ± 6.18	76.31 ± 5.75	0.534	0.594	−0.067

Clinical efficacy analysis

Group	Obvious effect (n)	Effective (n)	Ineffective (n)	Total effective rate n (%)
DT group	50	52	25	102 (80.31)
GD group	58	60	9	118 (92.91)
x²	7.236
P	<0.05

Pregnancy

Group	Cumulative pregnancy rate	Live birth rate	Miscarriage rate	Multiple pregnancy rate	Ectopic pregnancy rate
DT group	26 (20.47)	22 (17.32)	4 (3.15)	0 (0.00)	2 (1.57)
GD group	48 (37.80)	42 (33.07)	2 (1.57)	0 (0.00)	0 (0.00)
x²	7.868	6.827	0.205	-	2.020
P	<0.05	<0.05	0.651	-	0.155

Antibody indicators positive rate

Norm	Time	DT group	GD group	x²	P
AEmAb	Pre-treatment	38 (29.92)	37 (29.13)	0.024	0.877
	Post-treatment	22 (17.32)^*	9 (7.09)^*	4.735	<0.05
AsAb	Pre-treatment	39 (30.71)	40 (31.50)	0.011	0.917
	Post-treatment	22 (17.32)^*	8 (6.30)^*	5.944	<0.05
AZpAb	Pre-treatment	41 (32.28)	42 (33.07)	0.023	0.880
	Post-treatment	23 (18.11)^*	9 (7.09)^*	5.531	<0.05

* Discrepancy compared with pre-treatment, P < 0.05.

AEmAb, anti-endometrial antibody; AsAb, anti-sperm antibody; AZpAb, anti-zona pellucida antibody.

Comparison of sex hormone levels (x ± s)

Norm	Time	DT group	GD group	t	P	Effect size
FSH (U/L)	Pre-treatment	5.78 ± 1.34	5.84 ± 1.56	0.329	0.743	−0.041
	Post-treatment	4.03 ± 1.22^*	3.22 ± 1.39^*	−4.936	<0.001	0.619
LH (U/L)	Pre-treatment	6.42 ± 1.46	6.51 ± 1.38	0.505	0.614	−0.063
	Post-treatment	5.46 ± 1.21^*	4.21 ± 1.03^*	−8.865	<0.001	1.112
E2 (pg/mL)	Pre-treatment	72.82 ± 13.37	72.52 ± 15.96	−0.162	0.871	0.020
	Post-treatment	61.83 ± 12.91^*	50.22 ± 10.06^*	−7.994	<0.001	1.003

* Discrepancy compared with pre-treatment, P < 0.05.

E2, estradiol; FSH, follicle-stimulating hormone; LH, luteinizing hormone.

Comparison of inflammatory indicators (x ± s, ng/L)

Norm	Time	DT group	GD group	t	P	Effect size
CRP	Pre-treatment	6.20 ± 0.38	6.21 ± 0.39	0.207	0.836	−0.026
	Post-treatment	4.03 ± 0.39^*	3.25 ± 0.38^*	−16.143	<0.001	2.026
TNF-α	Pre-treatment	5.07 ± 0.50	5.01 ± 0.48	−0.976	0.330	0.122
	Post-treatment	2.39 ± 0.30^*	1.61 ± 0.29^*	−21.067	<0.001	2.644
IL-6	Pre-treatment	16.06 ± 2.21	15.78 ± 2.70	−0.904	0.367	0.113
	Post-treatment	12.39 ± 1.66^*	6.58 ± 1.67^*	−27.807	<0.001	3.489

* Discrepancy compared with pre-treatment, P < 0.05.

CRP, C-reactive protein; IL-6, interleukin-6; TNF-α, tumor necrosis factor-α.

VAS score (x ± s, score)

	DT group	GD group	t	P	Effect size
Pre-treatment	13.18 ± 1.94	13.10 ± 2.18	−0.309	0.758	0.039
Post-treatment	9.47 ± 1.50	7.58 ± 1.38	−10.450	<0.001	1.311
t	−17.049	−24.111
P	<0.001	<0.001
Effect size	2.140	3.026

[i] VAS, visual analog scale.

Occurrence of adverse reactions (n, %)

	DT group	GD group	x²	P
Nausea/vomiting	4 (3.15)	3 (2.36)	0.205	0.651
Hot flashes/sweating	1 (0.79)	0 (0.00)	1.005	0.316
Headache	2 (1.57)	1 (0.79)	0.338	0.561
Diarrhea	4 (3.15)	1 (0.79)	1.020	0.312
Vaginal bleeding	2 (1.57)	0 (0.00)	2.020	0.155
Pelvic inflammatory disease	2 (1.57)	0 (0.00)	2.020	0.155
Ovarian hyperstimulation syndrome	1 (0.79)	2 (1.57)	0.338	0.561
Urinary tract infection	2 (1.57)	0 (0.00)	2.020	0.155
Osteoporosis	1 (0.79)	0 (0.00)	1.005	0.316
Total response incidence	19 (14.96)	7 (5.51)	4.310	<0.05