Clinical diagnosis of pelvis edometriosis and the effect on the infertility by Laparoscopy

Objective To study the coincidence of diagnosis accurate for the endometriosis(EMT) by Laparoscopy with pathologic diagnosis and to observe clinical effect of Laparoscopic treatment on the infertile women with endometriosis.Methods ①About 180 cases with EMT were under resection operation for the EMT focus and distribute characteristic of EMT focus was observed and recorded.Peritoneum issues by macroscopic observation as normal were taken biopsy randomly.②Pregnancy rate and abortion rate of 95 infertile cases under Laparoscopic treatment among 180 cases were compared according to different stages.Results ①The positive predictive value(PPV) was 77.7%,the sensitivity was 90.5%,the negative predictive value(NPV) was 86.4% and the specificity was 41.2% by Laparoscopy diagnosed for 180 cases.In addition,38 cases accounting for 23.5% was positive identified as EMT by pathological examination among 162 samples under peritoneum biopsy.The peritoneal EMT focus almost located in posterior part of the pelvis.②Among all the 95 infertile cases,66 cases became pregnant in 36 weeks after surgery while the accumulative pregnancy rates were not significantly different among different stages(P0.05).The accumulative pregnancy rate within 24 weeks after surgery(77.3%,51/66) was higher than that within 25~36 weeks after surgery(22.7%,15/66) and the difference was significant(P0.05).Among 66 pregnancy cases,6 cases were abortion.The abortion rate was no correlation with EMT stages(P0.05).Conclusion ①The pathologic diagnosis rate of peritoneal blue EMT lesions or in sacral ligament are higher and the study shows unsymmetrical distribution of pelvic EMT as the lesion in the posterior and the left are more than those in the anterior part and the right.②Early lesions of endometriosis and pelvic factors for infertility can be found by Laparoscopy.And pregnancy rate in endometriosis cases can be improved by Laparoscopic surgery and the cases with EMT after Laparoscopic surgery should be guided to pregnant as soon as possible.