The factors influencing pregnancy after surgery in infertile patients with severe endometriosis.

Objective: Endometriosis is assumed to be one of the causes of infertility, although the mechanism remains unclear. The purpose of this study was to determine the prognostic factors for the fertility in women with severe endometriosis. Methods: Clinical data of 78 consecutive infertile patients who had taken surgery for stage III and IV endometriosis were retrospectively analyzed in two groups: A- pregnant after surgery (n=43, 55.1%): B- non-pregnant after surgery (n=35, 44.9%). All patients were treated with GnRHa after surgery. Each group were compared age, BMI, duration of infertility, stage of endometriosis, size and number of endometrioma, peritoneal implant outside the pelvic cavity, peritubal adhesion, ovarian adhesion and cul-de-sac obliteration. Results: Among these factors, duration of infertility (p=0.03), peritoneal implant (p=0.01), tubal adhesion (p=0.04) and ovarian adhesion (p=0.02) were significantly different. However, patients’ age, BMI, size and number of endometrioma, cul-de-sac obliteration and stage of endometriosis did not showed significantly different. Conclusion: We concluded that the duration of infertility and tubal and ovarian adhesion are important factors for predicting pregnancy after surgery in severe endometriosis.