Does surgery for deep infiltrating bowel endometriosis improve fertility? A systematic review

Maja Lundegaard Iversen, Mikkel Seyer-Hansen, Mikkel Seyer‐Hansen, Seyer-Hansen M, Axel Forman
Acta obstetricia et gynecologica Scandinavica · 2017 · vol. 96(6) , pp. 688–693 · doi:10.1111/aogs.13152 · PMID:28419418 · W2607271160
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This systematic review found insufficient high-quality data to conclude whether surgery for deep infiltrating bowel endometriosis improves fertility or IVF outcomes, despite a potential positive signal for spontaneous pregnancy.

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Abstract

INTRODUCTION: Reduced fertility is a major concern in women with endometriosis. The influence of surgery of deep infiltrating endometriosis (DIE) affecting the bowel wall on fertility is controversial and the literature on this field is heterogeneous. In this review we addressed whether surgery for bowel DIE improves the spontaneous pregnancy rate, and the results of in vitro fertilization (IVF), and the potential risk of such surgery. MATERIAL AND METHODS: We conducted a literature search including the terms "deep", "deep infiltrating", "bowel", rectovaginal", "endometriosis", "fertility", "infertility" and "IVF" in PubMed. RESULTS: No randomized controlled studies were found. Other publications of relevance included four retrospective and three prospective observational studies. Moreover, one retrospective study compared results of IVF treatment with or without previous surgery for bowel DIE. All studies reported detailed data on surgical complications. The poor data quality precluded firm conclusions. The results indicate, however, the possibility that surgery for bowel DIE may improve the spontaneous pregnancy rate, and positive effects on IVF outcome cannot be excluded. Such surgery will be associated with risk of major complications. CONCLUSION: The lack of proper data precludes conclusions on the potential role for bowel DIE surgery to improve the spontaneous pregnancy rate and results of IVF treatment. Positive effects cannot be excluded, but the definite risk of major complications must be taken into account.

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Condition tags

endometriosisdie_deep_infiltratingbowel_endometriosisinfertility

MeSH descriptors

Endometriosis Fertilization in Vitro Infertility, Female Endometriosis Endometriosis Endometriosis Female Fertilization in Vitro Humans Infertility, Female Infertility, Female Intestinal Diseases Intestinal Diseases Intestinal Diseases Intestinal Diseases Pregnancy Pregnancy Rate

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 (27)

Cited by (50)

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