The mean age was 33 years, all female, 25 patients in the GnRH group and 32 patients in the DNG group were assigned. The median size of the endometriosis was 7 cm (5-8 cm) with no significant difference between the two groups.
The pace of enrollment was about as expected compared to the pace initially predicted.
In the GnRHa group, 3 patients dropped out due to allergies, and in the DNG group, 2 patients did not consent to blood sampling, 1 patient was below the AMH threshold, 1 patient had emergency surgery, and 1 patient was not eligible for the study. The final analysis was 22 patients in the GnRHa group and 27 patients in the DNG group.
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GnRH agonistのアレルギーが3名に生じた
Allergies for GnRH antagonist treatment.
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本試験では、DNGの有効性を主要評価項目としてAMHを卵巣予備能の指標として評価した。結果として、DNG群はGnRHa群と比較して術後1年でのAMH値割合が高く、有効性が示された (two-tailed Student’s t-test)。 副次評価項目として血清FSH値、手術所見:手術時間、出血量、内膜症重症度(rASRMスコア)との関連を評価し、概ね両群に差は認めなかったが、血清FSH値の術後2ヶ月時点では有意差を認めた (Mann-Whitney U test)。
In this study, the efficacy of DNG was the primary endpoint, and AMH was evaluated as an index of ovarian reserve. The results showed that the DNG group had a higher percentage of AMH levels at 1 year postoperatively than the GnRHa group, indicating efficacy (two-tailed Student's t-test). As secondary endpoints, we evaluated the relationship between serum FSH level, surgical findings: operative time, blood loss, and endometriosis severity (rASRM score), and found that there was generally no difference between the two groups, but there was a significant difference in serum FSH level at 2 months postoperatively (Mann-Whitney U test).
Our data revealed that DNG is more effective than GnRHa in preserving ovarian reserve after cystectomy of ovarian endometrioma. This is achieved through the reduction of the inflammatory response during the perioperative period and other endometriosis-related inflammatory reactions.
The evaluation for usefulness of dienogest to prevent decline of ovarian reserve by cystectomy for endometriomas. (The evaluation for usefulness of dienogest to prevent decline of ovarian reserve by cystectomy for endometriomas.)
卵巣子宮内膜症性嚢胞摘出術後の卵巣予備能低下に対するジェノゲスト投与の有効性の検討
The evaluation for usefulness of dienogest to prevent decline of ovarian reserve by cystectomy for endometriomas (The evaluation for usefulness of dienogest to prevent decline of ovarian reserve by cystectomy for endometriomas)