The effects of gonadotropin releasing hormone agonist + add-back therapy on estrogen and progesterone receptors in uterine leiyomyoma and myometrial tissue and proliferation

SUMMARYObjectıve:The aim of this study was to evaluate the effect of GnRH-a + add-back therapy onuterine leiomyomas and myometrial receptor levels and proliferation byimmunhistochemical technique.Study design:Twenty healty women, who had symptomatic leiomyomas and myomectomy orhysterectomy were planned, were divided in to two groups.The patients received GnRH-a infirst group and GnRH-a+add-back therapy (Tibolone) in second group along three months.Before the treatment, the diameter of uterus and leiomyomas were measured byultrasonography and the volumes of uterus and leiomyomas were calculated according tothe formula of Ğ¿/6x (D1xD2xD3). The values of Hb, Htc of all subjects were recorded atthe time of first GnRH-a injection, day of operation and postoperative 24th hour. Thediameter and volume of uterus-leiomyomas, the values of Hb and Htc were comparedwithin and between the groups at the end of study.The level of estrogen receptors, progesterone receptors and Ki-67 in leiomyomas andmyometrial tissue were compared between the groups at the end of study.Results:The amount of intraoperatif hemorrhage was decreased in both groups. The size ofuterus and leiomyoma were decreased significantly in GnRH-a+add-back therapy.Conclusions:In this study we found that giving add-back therapy for decreasing thehypoestrogenic adverse reactions of GnRH-a reduced the amount of intraoperativehemorrhage, the size and volume of uterus and leiomyomas, but it didn?t change the effectof GnRH on proliferation and receptor levels. We think that this result is due to tibolonewhich has weak estrogenic, progestagenic and androgenic effect.