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Pelvic Adhesion and Gonadotropin-Releasing Hormone Analogue: Effects of Triptorelin Acetate Depot on Coagulation and Fibrinolytic Activities

Abstract

The study investigated the impact of gonadotropin-releasing hormone analogue (GnRH-a) on coagulation and fibrinolytic activities and its effectiveness in the prevention of pelvic adhesion after myomectomy. Thirty-two infertile women underwent myomectomy followed by adhesion evaluation surgery with a second-look laparoscopy. Before myomectomy, 15 women were treated with triptorelin acetate for 3 months and 17 received no treatment. Plasminogen activator inhibitor (PAI), thrombin activatable fibrinolysis inhibitor (TAFI), protein C (PC), plasminogen, α2-antiplasmin were determined by enzyme-linked immunosorbent assays and the activity of coagulation factors V and VIII by coagulometric methods. Patients treated with GnRH-a showed significant decrease in PAI, TAFI, factors V, and VIII (P < .05) and increased PC (P < .05), but no significant change in plasminogen and α2-antiplasmin levels compared with control group. The incidence, extent, and severity of adhesions were significantly lower in GnRH-a-treated patients compared with control group (P < .05), suggesting a possible critical role of the GnRH-a therapy in preventing postoperative adhesion development.

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Correspondence to Maria Antonietta Di Nardo MD.

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Di Nardo, M.A., Annunziata, M.L., Ammirabile, M. et al. Pelvic Adhesion and Gonadotropin-Releasing Hormone Analogue: Effects of Triptorelin Acetate Depot on Coagulation and Fibrinolytic Activities. Reprod. Sci. 19, 615–622 (2012). https://doi.org/10.1177/1933719111428517

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Keywords

  • coagulation system
  • gonadotropin-releasing hormone analogue
  • fibrinolytic system
  • myomectomy
  • pelvic adhesion