Infertility and endometriosis: Comparison of pregnancy outcomes with laparotomy versus laparoscopic techniques

Gant NF, N F Gant, Norman F. Gant
American journal of obstetrics and gynecology · 1992 · vol. 166(4) , pp. 1072–1081 · doi:10.1016/s0002-9378(11)90592-4 · PMID:1533089 · W1999737585
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This study compared pregnancy outcomes between laparotomy and laparoscopic techniques for treating endometriosis-related infertility.

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Abstract

ObjectivesThe null hypothesis of this retrospective literature analysis was that the superiority of laparoscopy over laparotomy to correct infertility resulting from tubal injury has not been proved because of the lack of well-designed comparative studies. The same was true for the correction of infertility caused by minimal and mild endometriosis.Study designA retrospective review of the English-language literature since 1975 was made to ascertain whether laparoscopic surgical correction of infertility caused by tubal injury and endometriosis resulted in an increased pregnancy rate compared with laparotomy techniques. Complication rates associated with laparoscopy versus laparotomy were also compared.ResultsThere were almost no adequate studies designed and executed to answer these questions based on criteria established by the United States Preventive Services Task Force. Furthermore, there was no evidence in the reported series that laparoscopic surgical procedures were superior to laparotomy in correcting infertility. The complication rates were similar. There was suggestive, but not yet proven, evidence that laparoscopic surgery with laser techniques may be superior to laparotomy in the management of infertility resulting from moderate and severe endometriosis.ConclusionAlthough results and complications were similar, the cost in savings with respect to decreased hospital expenses and loss of work time favor the use of laparoscopy over laparotomy when results are similar and not associated with increased risk. What has not been established are costs and work-time losses for minilaparotomy compared with laparoscopy.

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Condition tags

endometriosisinfertility

MeSH descriptors

Endometriosis Infertility, Female Laparoscopy Laparotomy Endometriosis Evaluation Studies as Topic Female Humans Infertility, Female

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (30)

Cited by (18)

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