Surgical Treatment of Deep Endometriosis: Impact on Spontaneous Conception

In: Endometriosis-related Infertility · 2024 · pp. 149–161 · doi:10.1007/978-3-031-50662-8_12 · W4392309334
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This paper discusses whether deep endometriosis excision improves natural fertility, noting observational studies report 40-50% spontaneous conception rates and recommending tailored infertility treatment and laparoscopic surgery.

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This chapter examines whether excision of deep endometriosis (DE) should be performed to improve natural fertility, synthesizing evidence largely from retrospective and prospective observational studies of infertile women with DE undergoing surgery. The authors report that uncontrolled studies after DE surgery have shown spontaneous pregnancy rates of roughly 40–50%, while emphasizing that patients should be informed about postoperative probability of spontaneous conception and potential surgical morbidity; a noted caveat is the reliance on nonrandomized data and the lack of control for confounding. The chapter also states that if surgery is done, completion by laparoscopy is expected to increase chances of spontaneous conception, and that infertility treatment choices should be individualized based on pain, prior surgery, age, ovarian reserve, endometrioma size, tubal patency, and semen analysis. This paper is centrally about endometriosis — it focuses on surgical treatment of deep endometriosis and its impact on spontaneous conception.

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Abstract

It is debated if the excision of deep endometriosis (DE) should be performed to improve natural fertility. Most of the available data in this setting are based on retrospective or prospective observational studies. These uncontrolled published studies reported a spontaneous pregnancy rate after surgery for DE of approximately 40–50%. Infertile patients with DE must be carefully informed of the actual probability of postoperative spontaneous conception and the potential morbidity associated with the proposed intervention. If surgery is performed, the procedure must be completed by laparoscopy to increase the chance of spontaneous conception. The type of infertility treatment should be tailored to the patient considering the intensity of pain symptoms, history of previous surgery, women’s age, ovarian reserve, presence of large endometriomas, tubal patency, and semen analysis. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

References

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Author information Authors and Affiliations Editor information Editors and Affiliations Rights and permissions Copyright information © 2024 The Author(s), under exclusive license to Springer Nature Switzerland AG About this chapter Cite this chapter Ferrero, S., Perrone, U., Sertoli, C., Falcone, F., Malzoni, M. (2024). Surgical Treatment of Deep Endometriosis: Impact on Spontaneous Conception. In: Ferrero, S. (eds) Endometriosis-related Infertility. Springer, Cham. https://doi.org/10.1007/978-3-031-50662-8_12 Download citation DOI: https://doi.org/10.1007/978-3-031-50662-8_12 Published: Publisher Name: Springer, Cham Print ISBN: 978-3-031-50661-1 Online ISBN: 978-3-031-50662-8 eBook Packages: MedicineMedicine (R0)

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