Factors Associated With Spontaneous Conception Leading to Live Birth in Infertility Patients After Endometriosis Surgery

Nguyen AD, Anthony D. Nguyen, Marshall HL, Hannah L Marshall, Hannah Marshall, Meg Wright Sidle, Meg W Sidle, Sidle MW, Veronica D. Galaviz, Sticco PL, Peter L. Sticco, Downing KT, Keith T Downing, Keith Downing
Journal of Minimally Invasive Gynecology · 2025 · vol. 32(8) , pp. 718–724 · doi:10.1016/j.jmig.2025.03.010 · PMID:40127888 · W4408734219
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This study identified factors associated with spontaneous conception and live birth in infertility patients following endometriosis surgery.

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Abstract

STUDY OBJECTIVE: To determine factors associated with spontaneous conception leading to live birth in infertility patients after endometriosis surgery. DESIGN: Retrospective cohort study. SETTING: Multi-hospital health system of Catholic Health in Long Island, NY. PARTICIPANTS: Infertility patients, between ages 18 and 45, who underwent endometriosis surgery with complete excision or ablation with or without excision and continued follow-up care for at least 1 year between January 1st, 2016 and March 31st 2022. MAIN RESULTS: Of the 100 patients, 50 achieved spontaneous conception and 40 achieved live birth within 1 year of surgery. Age less than 35 at the time of surgery was found to have an increased likelihood of live birth (RR 3.1, 95% CI 1.3-7.2). Being overweight (RR 1.0, 95% CI 0.4-2.2) or obese (RR 1.2, 95% CI 0.4-3.1) did not affect the likelihood of live birth. Surgery within 24 months of infertility diagnosis did not increase the likelihood of a successful delivery (RR 2.0, 95% CI 0.9-4.5). The pregnancy rate for AAGL Stage I, II, III, IV endometriosis were 42% (18/32), 32% (8/25), 46% (6/13), 42% (8/19) respectively. The logistic regression model indicated that live birth after spontaneous conception was significantly associated with younger age at the time of surgery and complete excision of endometriosis. Patients were 3.2 times (95% CI 1.3-7.8) more likely of having a live birth if they were less than 35 years old at the time of surgery. Complete excision of endometriosis conferred a 4.1-fold (95% CI 1.1-14.9) increased likelihood of a live birth. CONCLUSION: Two factors increased the likelihood of live birth after endometriosis surgery: age at the time of surgery and complete excision of endometriosis. We cautiously recommend patients attempting spontaneous conception find an endometriosis surgeon proficient in excisional techniques. If they are under 35, there may be additional benefit from surgery.

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Condition tags

endometriosisinfertility

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis

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.

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