Colorectal endometriosis-associated infertility: should surgery precede ART?

Sofiane Bendifallah, Bendifallah S, Roman H, Horace Roman, Mathieu d'Argent E, Emmanuelle Mathieu d'Argent, Emmanuelle Mathieu d’Argent, Touleimat S, Salma Touleimat, Cohen J, Jonathan Cohen, Darai E, Emile Darai, Émile Daraï, Marcos Ballester, Ballester M
Fertility and sterility · 2017 · vol. 108(3) , pp. 525–531.e4 · doi:10.1016/j.fertnstert.2017.07.002 · PMID:28807397 · W2744232943
article OA: bronze CC0 ⤵ 68 in-corpus citations
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This paper reviews the role of surgical intervention for colorectal endometriosis in women undergoing assisted reproductive technologies (ART) for infertility.

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Abstract

ObjectiveTo compare the impact of first-line assisted reproductive technology (ART; intracytoplasmic sperm injection [ICSI]-IVF) and first-line colorectal surgery followed by ART on fertility outcomes in women with colorectal endometriosis-associated infertility.DesignRetrospective matched cohort study using propensity score (PS) matching (PSM) analysis.SettingUniversity referral centers.Patient(s)A total of 110 women were analyzed from January 2005 to June 2014. A PSM was generated using a logistic regression model based on the age, antimüllerian hormone (AMH) serum level, and presence of adenomyosis to compare the treatment strategy.Intervention(s)First-line surgery group followed by ART versus exclusive ART with in situ colorectal endometriosis.Main outcome measure(s)After PSM, pregnancy rates (PRs), live-birth rates (LBRs), and cumulative rates (CRs) were estimated.Result(s)After PSM, in the whole population, the total LBR and PR were 35.4% (39/110) and 49% (54/110), respectively. The specific cumulative LBR at the first ICSI-IVF cycle in the first-line surgery group compared with the first-line ART was, respectively, 32.7% versus 13.0%; at the second cycle, 58.9% versus 24.8%; and at the third cycle, 70.6% versus 54.9%. The cumulative LBRs were significantly higher for women who underwent first-line surgery followed by ART compared with first-line ART in the subset of women with good prognosis (age ≤ 35 years and AMH ≥ 2 ng/mL and no adenomyosis) and women with AMH serum level < 2 ng/mL.Conclusion(s)First-line surgery may be a good option for women with colorectal endometriosis-associated infertility.

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Condition tags

endometriosisinfertility

MeSH descriptors

Endometriosis Endometriosis Infertility, Female Infertility, Female Pregnancy Outcome Reproductive Techniques, Assisted Adult Combined Modality Therapy Combined Modality Therapy Comorbidity Endometriosis Female France France Humans Infertility, Female Infertility, Female Intestinal Diseases Intestinal Diseases Intestinal Diseases

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

References (41)

Cited by (50)

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