Spontaneous fertility after expectant or surgical management of rectovaginal endometriosis in women with or without ovarian endometrioma: a retrospective analysis

Umberto Leone Roberti Maggiore, Scala C, Carolina Scala, Emanuela Tafi, Tafi E, E. Tafi, Annalisa Racca, Racca A, Ennio Biscaldi, Biscaldi E, Valerio Gaetano Vellone, Pier Luigi Venturini, Venturini PL, Simone Ferrero
Fertility and sterility · 2017 · vol. 107(4) , pp. 969–976.e5 · doi:10.1016/j.fertnstert.2017.02.106 · PMID:28366418 · W2598984013
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This retrospective analysis examined spontaneous fertility rates in women with rectovaginal endometriosis, comparing outcomes between expectant and surgical management, with or without ovarian endometrioma.

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Abstract

OBJECTIVE: To investigate spontaneous pregnancy rate (SPRs) of women with rectovaginal endometriosis (RV) with/without ovarian endometrioma (OMA) and treated with the use of expectant or surgical management. DESIGN: Retrospective study. SETTING: University hospital. PATIENT(S): The study included patients with RV with or without OMA who tried to conceive spontaneously for 1 year either without undergoing surgery (group E; n = 284) or after surgery (group S; n = 221). The study population was further divided into four subgroups: women with RV without OMA who directly tried to conceive (group eRV; n = 121) or tried to conceive after surgery (group sRV; n = 96), and women with RV with OMA who directly tried to conceive (group eOMA; n = 163) or tried to conceive after surgery (group sOMA; n = 125). INTERVENTIONS(S): Expectant or surgical management. MAIN OUTCOME MEASURE(S): Crude and cumulative SPRs. RESULT(S): At 1 year, crude and cumulative SPRs were lower in group E (17.3% and 23.8%, respectively) than in group S (35.7% and 39.5%). Similarly, crude and cumulative SPRs were lower in group eRV (24.8% and 30.6%) than in group sRV (42.7% and 45.7%, respectively) and in group eOMA (11.7% and 18.0%) than group sOMA (30.4% and 34.5%). At 1 year, crude and cumulative SPRs were higher in group eRV (24.8% and 30.6%) than in group eOMA (11.7% and 18.0%), and in group sRV (42.7% and 45.7%) than in group sOMA (30.4% and 34.5%). CONCLUSION(S): Crude and cumulative SPRs are lower in women treated with the use of expectant rather than surgical management. The presence of OMAs decreases SPRs independently from the treatment modality adopted.

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Condition tags

endometriosisendometriomabowel_endometriosis

MeSH descriptors

Endometriosis Fertility Fertility Infertility, Female Ovarian Diseases Rectal Diseases Vaginal Diseases Adult Adult Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Female Female Hospitals, University Hospitals, University Humans Humans

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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. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

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Cited by (31)

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