The therapeutic method of the patients with endometriosis associated infertility after laparoscopic management

Objective To discuss an effective method to improve pregnancy rate after laparoscopic management of endometriosis in an infertile population.Methods The clinical data of 331 infertility patients with endometriosis treated using laparoscopic surgery between Jan.2006 and Jan.2008 were analyzed.These patients were divided into 4 groups according to various protocols after their laparoscopic surgery.Group A(n=82): the patients tried to pregnancy directly after laparoscopic surgery.Group B(n=81):the patients with laparoscopic surgery were treated with assisted reproductive technology(ART) after more than one year infertility.Group C(n=90): the patients with laparoscopic surgery used Nuolei De(GnRH-a) adjuvant therapy for 3 months and tried to pregnancy.Group D(n=78): the patients with laparoscopic surgery used Nuolei De adjuvant therapy for 3 months and were treated with ART.Results After 2 years,the cumulative pregnancies of group A,B,C and D in Ⅲ and Ⅳ stages were 32.7%(17/52),58.0%(29/50),45.2%(28/62) and 59.6%(31/52) respectively.The cumulative pregnancies of group A were significantly lower than that of B and D groups(P0.01),however the difference between group A and group C between group C and groups B and D,between group B and group D was all not statistically significant(P0.05).Conclusion ART can improve pregnancy rate of the infertility patients with endometriosis in Ⅲ and Ⅳ stages after they were treated using laparoscopic surgery.The need of medication after laparoscopic surgery and the timing of ART should be based on age,infertility duration and severity of patients.An individual treatment should be made for each patient.