Laparoscopic surgery in the treatment of 86 patients with pelvic endometriosis compicated with infertility

Objective To observe the effect of laparoscopy on diagnosis and treatment of pelvic endometriosis complicated with infertility.Methods Totally 86 cases of endometriosis complicated with infertility diagnosed by laparoscopy were choosed.According to the revised classification of American Fertility Society (r-AFS),there were 6 cases of stage Ⅰ,39 cases of stage Ⅱ,22 cases of stage Ⅲ,9cases of stage Ⅳ.Operation were done under laparoscopy,with ovary ectopic endometrium resection and pelvic peritoneal adhesions decomposition,ectopic endometrium solidified operation and removal of the peritoneal fluid.All patients were followed up for 36 weeks,pregnancy follow-up to 20 weeks.The postoperative cumulative pregnancy rates were compared between different r-AFS stage patients.Results Of all the 86 cases,a total of 61 cases of pregnancy during 36 weeks after surgery,stage Ⅰ in 12 cases (75.0％,12/16),stage Ⅱ in 28 cases (71.8％,28/39),stage Ⅲ in 15 cases (68.2％,15/22) and stage Ⅳ in 6 cases (66.7％,6/9).There was no significant difference in cumulative pregnanay rate among different stages (P ＞0.05).The pregnancy rate (70.5％,43/61) during 24 weeks after surgery was higher than that during 25-36 weeks after surgery (29.5％,18/61),there was significant difference (P ＜ 0.01).Conclusions Laparoscopy can significantly improve the diagnosis of endometriosis and pregnancy rate in patients with endometriosis.Cleaning the peritoneal fluid and abdominal ectopic endometrial lesions,coagulation,may more thoroughly destroy the pelvic peritoneal ectopic endometrial lesions,so it plays an importment role in fertility recovery of uterine endometriosis patients,espicially for patients with stage Ⅰ and Ⅱ. Key words: Endometriosis ;  Infertility ;  Laparoscopy ;  Electrocoagulation