Clinical evaluation of laparoscopic surgery combined with triptorelin acetate in patients with endometriosis and infertility

Abstract

Objective:To investigate the effects of laparoscopic surgery combined with triptorelin acetate, gestrinone and mifepristone on pregnancy rate, pregnancy outcome, long-term recurrence and adverse reactions in patients with endometriosis (EMT) complicated with infertility.Methods:In this study, 150 patients with EMT and infertility were selected and randomly divided into triptorelin group (group A), gestrinone group (group B) and mifepristone group (group C), with 50 people in each group. Treatment was with gonadotropin-releasing hormone (GnRH-a) after laparoscopic surgery.Results:The success rate of pregnancy in group A was higher than that in group B and C. The incidence of adverse pregnancy outcome was lower than that in group B and C. Kupperman score and subjective symptom score were lower than those in group B and C before treatment. Sex hormone level and CA125 level were significantly better. In the B and C groups and before treatment; the long-term recurrence rate was significantly lower than the B and C groups; the incidence of adverse reactions was similar.Conclusion:Laparoscopic surgery combined with GnRH-a can improve the success and good rate of pregnancy in EMT patients, reduce clinical symptoms, avoid long-term recurrence, and increase the risk of adverse reactions. Triptorelin acetate is superior to gestrinone and mifepristone.

Assessment of Two Formulations of Triptorelin in Chinese Patients with Endometriosis: A Phase 3, Randomized Controlled Trial

“…Both formulations of triptorelin had a beneficial treatment effect, demonstrated by the proportion of patients chemically castrated after treatment and reduction in endometriosis-associated pelvic pain, which was similar between groups and consistent with numerous previous studies of triptorelin in the management of endometriosis [ 13 , 24 – 26 ]. In addition, the present findings are consistent with a previous phase 2, prospective, randomized, open-label study comparing the 3-month formulation and 1-month formulation of triptorelin in 146 European women with endometriosis [ 19 ].…”

“…Consistent with previous studies, the most common AEs in patients treated with triptorelin were hot flashes and night sweats [14,27]. The safety profiles of triptorelin pamoate PR 3-month and triptorelin acetate PR 1-month were also consistent with previous studies of triptorelin acetate PR 1-month, which reported that the formulation was generally well tolerated and did not result in serious AEs [24,26].…”

The efficacy and safety of up to 24 weeks of triptorelin therapy following conservative surgery in patients with deep infiltrating endometriosis (DIE): a multicentre, prospective, non-interventional study in China

“…26 However, as the study did not directly capture how many women tried to become pregnant during the 24 months follow-up, the interpretation of this observation is unclear. Furthermore, the present 24-month pregnancy rate for infertile patients was substantially lower than the 24-month pregnancy rate of 80% observed in infertile patients treated with triptorelin in the randomized controlled trial by Xue et al 19 A possible reason for this difference is the older age of patients in this study compared with the study by Xue et al (mean age, 33.4 vs. 26.7 years), as the problem of infertility is greater and the planning of pregnancy less common in older patients.…”

“…The most common adverse effects in patients treated with triptorelin were menopause symptoms (hot flash/flush, sweat/night sweat) in agreement with results from previous studies. 15,16,19,29…”

“…10 Triptorelin is one of the most commonly used GnRH-a and has been demonstrated to improve the symptoms and fertility outcomes of patients with DIE. 15,16 Although multiple studies have shown that GnRH-a treatment after surgery can improve post-operative pain and may facilitate a reduction in the rate of symptom recurrence, [17][18][19] the effectiveness and optimal duration of GnRH-a treatment after surgery in DIE are still debated in China. This study aimed to evaluate whether up to 24 weeks of treatment with triptorelin following conservative surgery can help manage the symptoms of patients with DIE, reduce symptom recurrence rate, and improve fertility status over a 24-month follow-up period in clinical practice in China.…”