The Value of the r-AFS on Medical Therapy after Laparoscopic Treatment of Endometriomas

Objective:To evaluate the clinical value of the American Fertility Society(r-AFS) score to guide the combined medical therapy after laparoscope in the patients with severe endometriosis.Methods: We retrospectively reviewed 255 patients with endometriosis about the diagnosis,surgery,and r-AFS score obtained under laparoscope.The patients,in the stage of Ⅲ-Ⅳ,were administrated with drugs after the surgeries,and the effects of medical treatment of both short and long terms were assessed.Results:Amang these 255 patients,65,61,79 and 50 cases were assigned to stageⅠ,Ⅱ,Ⅲ and Ⅳ respectively according to r-AFS.Drugs were administrated to 129 patients for 3-6 months in the stage of Ⅲ-Ⅳ,while not to the patients in the stage of Ⅰ-Ⅱ.The following up of 87 patients at 1-3 years showed a complete relief of the pain in 45 cases(51.7%),effective relief of pain in 80 cases(91.9%),and partial relief of pain in 5 cases(5.7%).Among the 87 patients,21 cases have gestations over the 1-3 years,with the total pregnancy rate reaches 48.8% and the recurrence rate is 14.9%.Conclusions:Combination of medical therapy after the surgery is important for patients with endometriosis.The r-AFS scores by laparoscope have marked significance to assess the severity of the disease,to choose individual therapy,and to instruct us whether medical treatment is needed.And such combination can effectively alleviate the pelvic pain,increase the pregnancy rate,and decrease the recurrence rate for the patients in the stage of Ⅲ-Ⅳ.