The benefit of adenomyomectomy on fertility outcomes in women with rectovaginal endometriosis with coexisting adenomyosis

Yohei Kishi, Maki Yabuta
Gynecology and minimally invasive therapy · 2016 · vol. 6(1) , pp. 20–24 · doi:10.1016/j.gmit.2016.08.002 · PMID:30254864 · W2519898124
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This retrospective study of 190 women with rectovaginal endometriosis found no significant difference in pregnancy rates after adenomyomectomy, though age at surgery was a critical factor.

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Abstract

STUDY OBJECTIVE: To evaluate the effect of removal of coexisting adenomyosis on fertility outcomes in women with rectovaginal endometriosis. DESIGN: A retrospective cohort study. SETTING: A general hospital. PATIENTS: A total of 190 women who underwent laparoscopic nodule excision surgery for rectovaginal endometriosis between April 2007 and December 2012. INTERVENTIONS: Surgical excision of the rectovaginal endometriosis and coexisting uterine adenomyosis. Statistical analysis for fertility outcomes. MEASUREMENT AND MAIN RESULTS: A total of 119 women desired postoperative pregnancy. Coexisting adenomyosis was found in 21% of the women. The overall clinical pregnancy rate was 41.2%. The only determining factor associated with a successful pregnancy was "age at surgery". Clinical pregnancy rates with or without adenomyosis were 36.0% and 42.6%, respectively. We found no significant difference in clinical pregnancy rates between the groups. CONCLUSION: There is a possibility that surgical removal of coexisting adenomyosis positively effects fertility outcomes in women with rectovaginal endometriosis. However, it is also important to note that the age at surgery was a critical factor for successful pregnancy.

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Condition tags

endometriosisadenomyosisbowel_endometriosis

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