Influence of Pelvic Endometriosis and Ovarian Endometrioma on Fertility

Akira Fujishita, Fujishita A, Khaleque Newaz Khan, Khan KN, Hideaki Masuzaki, Masuzaki H, Tadayuki Ishimaru, Ishimaru T
Gynecologic and obstetric investigation · 2002 · vol. 53(Suppl. 1) , pp. 40–45 · doi:10.1159/000049423 · PMID:11834867 · W2057744712
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Pregnancy rates in women with endometriosis were not affected by r-AFS stage, ovarian endometrioma, or cul-de-sac obliteration but were significantly reduced by bilateral tubal occlusion as defined by the TOP classification.

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Abstract

We investigated the influence of pelvic endometriosis and ovarian endometrioma on pregnancy outcome in women associated with infertility. A total of 237 women with endometriosis were reviewed, and their fertility rate was assessed by both r-AFS staging and TOP classification as previously proposed by our group. There was no significant difference in pregnancy rate among r-AFS stages. However, the pregnancy rate was mostly affected by the tubal condition according to the TOP classification as follows: no adhesive lesion (T0), 53% (69/129); unilateral lesion (T1), 46% (18/39); bilateral lesion with at least one tube patent, (T2), 37% (10/27); bilateral tubal occlusion (T3), 0% (0/8) (p < 0.05, Mantel-Extension test). The absence (O0-O1) or co-existence (O2-O3) of ovarian endometrioma and different gradings of cul-de-sac obliteration (P2-P3) showed no significant differences in pregnancy rate. The resulting conception rate was also not affected by the size or location of ovarian endometrioma. In addition, the higher adhesion score of ovarian endometrioma involving the fallopian tube and as described in r-AFS classification had a significant detrimental effect on fertility. These observations suggest that our TOP classification describing individual tubal condition has a clinically predictive value in assessing the reproductive outcome of women with endometriosis.

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Outcome instruments

AFS

Condition tags

endometriosisendometriomainfertility

MeSH descriptors

Endometriosis Fallopian Tubes Infertility, Female Ovarian Diseases Ovarian Neoplasms Pregnancy Adult Endometriosis Endometriosis Endometriosis Fallopian Tubes Fallopian Tubes Female Humans Incidence Infertility, Female Infertility, Female Infertility, Female Laparoscopy Laparoscopy

Citation neighborhood

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. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (9)

Cited by (21)

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