Efficacy of laparoscopic surgery for infertile women with endometriosis

Setsuko Yamamoto, Michiko Umeki, Tomoko Maeda
In: JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY · 2010 · vol. 26(2) , pp. 521–525 · doi:10.5180/jsgoe.26.521 · W2333194652
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-12 ⓘ

Laparoscopic surgery improved pregnancy rates for infertile women with no or unilateral endometriomas, but bilateral endometriomas correlated with lower rates, suggesting ART might be better.

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This retrospective study evaluated the efficacy of laparoscopic surgery as first-line management for 209 infertile women with endometriosis treated at an ART center in Japan, comparing characteristics and outcomes between pregnant and nonpregnant patients. The authors assessed how age, infertile duration, revised AFS score, and peritubal/periovarian adhesion measures related to pregnancy rates, and they compared cumulative pregnancy rates by endometrioma laterality (no, unilateral, bilateral), including cases receiving ART. Pregnancy rates were negatively correlated with an infertile period >3 years and mean adhesion score >21 points, and pregnancy rates after surgery and after ART did not differ significantly across disease stages, while cumulative pregnancy rate was lower in bilateral endometriomas (53.8%) than in no (76.1%) or unilateral (80.5%) disease. The study is limited by its retrospective design and by the need for prospective studies to test the proposed pathway differences. This paper is centrally about endometriosis — it assesses laparoscopic surgery outcomes for infertile women with endometriosis and stratifies results by infertility duration and bilateral versus unilateral endometriomas.

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Abstract

Objective: To determine the efficacy of laparoscopic surgery for managing infertile patients with endometriosis.Design: Retrospective study.Setting: Assisted Reproductive technology (ART) Center, Fukuda Hospital, Kumamoto, Japan.Patient(s): Consecutive total of 209 infertile patients who had undergone laparoscopic surgery for endometriosis as a first-line therapy were enrolled.Intervention(s): Eighty-three women were also involved in ART programs.Main Outcome Measure(s): Age, infertile period, revised American Fertility Society (re-AFS) score, peritubal and periovarian adhesions were compared between pregnant and nonpregnant patients. We also evaluated the pregnancy rate and infertile period, adhesion score and re-AFS score. We compared cumulative pregnancy rates in patients with no (Group CF, n = 142), unilateral (Group U, n = 41) and bilateral endometriomas (Group B, n = 26).Result(s): An infertile period > 3 years and a mean adhesion score > 21 points were negatively correlated with pregnancy rates. There were no significant differences in pregnancy rates after surgery and after ART across the four disease stages. The cumulative pregnancy rate of Group B (53.8%) was significantly lower than Groups CF (76.1%) (p<0.01) and U (80.5%) (p 2 years should be encouraged to undergo laparoscopic surgery. However, encouraging such women with bilateral endometriomas to move directly to ART might improve their ability to achieve a pregnancy. Further prospective studies are necessary to test this hypothesis.
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Original Efficacy of laparoscopic surgery for infertile women with endometriosis 2010 Volume 26 Issue 2 Pages 521-525 Details Abstract Objective: To determine the efficacy of laparoscopic surgery for managing infertile patients with endometriosis. Design: Retrospective study. Setting: Assisted Reproductive technology (ART) Center, Fukuda Hospital, Kumamoto, Japan. Patient(s): Consecutive total of 209 infertile patients who had undergone laparoscopic surgery for endometriosis as a first-line therapy were enrolled. Intervention(s): Eighty-three women were also involved in ART programs. Main Outcome Measure(s): Age, infertile period, revised American Fertility Society (re-AFS) score, peritubal and periovarian adhesions were compared between pregnant and nonpregnant patients. We also evaluated the pregnancy rate and infertile period, adhesion score and re-AFS score. We compared cumulative pregnancy rates in patients with no (Group CF, n = 142), unilateral (Group U, n = 41) and bilateral endometriomas (Group B, n = 26). Result(s): An infertile period > 3 years and a mean adhesion score > 21 points were negatively correlated with pregnancy rates. There were no significant differences in pregnancy rates after surgery and after ART across the four disease stages. The cumulative pregnancy rate of Group B (53.8%) was significantly lower than Groups CF (76.1%) (p<0.01) and U (80.5%) (p 2 years should be encouraged to undergo laparoscopic surgery. However, encouraging such women with bilateral endometriomas to move directly to ART might improve their ability to achieve a pregnancy. Further prospective studies are necessary to test this hypothesis. Design: Retrospective study. Setting: Assisted Reproductive technology (ART) Center, Fukuda Hospital, Kumamoto, Japan. Patient(s): Consecutive total of 209 infertile patients who had undergone laparoscopic surgery for endometriosis as a first-line therapy were enrolled. Intervention(s): Eighty-three women were also involved in ART programs. Main Outcome Measure(s): Age, infertile period, revised American Fertility Society (re-AFS) score, peritubal and periovarian adhesions were compared between pregnant and nonpregnant patients. We also evaluated the pregnancy rate and infertile period, adhesion score and re-AFS score. We compared cumulative pregnancy rates in patients with no (Group CF, n = 142), unilateral (Group U, n = 41) and bilateral endometriomas (Group B, n = 26). Result(s): An infertile period > 3 years and a mean adhesion score > 21 points were negatively correlated with pregnancy rates. There were no significant differences in pregnancy rates after surgery and after ART across the four disease stages. The cumulative pregnancy rate of Group B (53.8%) was significantly lower than Groups CF (76.1%) (p<0.01) and U (80.5%) (p 2 years should be encouraged to undergo laparoscopic surgery. However, encouraging such women with bilateral endometriomas to move directly to ART might improve their ability to achieve a pregnancy. Further prospective studies are necessary to test this hypothesis. © 2010 Japan Society of Gynecologic and Obstetric Endoscopy and Minimally Invasive Therapy Favorites & Alerts Recently viewed articles

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endometriosisinfertility

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