Surgical Treatment of Deep Endometriosis: Impact on Spontaneous Conception
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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References (39)
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