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

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. 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.