Fertility outcomes following laparoscopic management of endometriosis: a prospective study from a tertiary fertility centre

Anu Nandita, Sundar Narayanan
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2026 · vol. 15(5) , pp. 1734–1737 · doi:10.18203/2320-1770.ijrcog20261277 · W7159683700
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This prospective study found a 45.29% pregnancy rate in 53 endometriosis patients undergoing laparoscopic surgery, suggesting improved fertility potential.

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This prospective study evaluated fertility outcomes after laparoscopic management of endometriosis in 53 women treated at a tertiary fertility center in Tamil Nadu from 2018 to 2022, including follow-up after procedures such as laparoscopic cystectomy, adhesiolysis, and fulguration of endometriotic lesions. The cohort had a high prevalence of primary infertility (86.7%) and most cases were advanced (stage III–IV), with pregnancy reported as an overall fertility outcome after surgery. The overall pregnancy rate following laparoscopic treatment was 45.29%, and the authors conclude this improves fertility potential and can inform subsequent assisted reproductive planning. The paper’s key limitation is that it does not provide a control/comparator group or detailed stratified outcome analyses within the provided text. This paper is centrally about endometriosis — it reports prospective fertility outcomes after laparoscopic endometriosis surgery.

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Abstract

Background: Endometriosis is a common gynecological disorder affecting approximately 10–15% of reproductive-aged women and is strongly associated with infertility and pelvic pain. Laparoscopic surgery plays an important role in the diagnosis and management of endometriosis. This study aimed to evaluate fertility outcomes following laparoscopic management of endometriosis. Methods: This prospective study was conducted at Sudha Sundar Fertility Hospital, Tamil Nadu between January 2018 and August 2022. A total of 53 women diagnosed with endometriosis who underwent laparoscopic surgery were included. Procedures included laparoscopic cystectomy, adhesiolysis, and fulguration of endometriotic lesions. Patients were followed up for fertility outcomes. Results: Most patients belonged to the age group of 31–35 years (43.3%). Primary infertility was present in 86.7% of patients. Advanced disease (stage III–IV) was observed in the majority of cases. The overall pregnancy rate following laparoscopic treatment was 45.29%. Conclusions: Laparoscopic management of endometriosis improves fertility potential and assists in planning further assisted reproductive techniques when required.
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Background

Endometriosis is a common gynecological disorder affecting approximately 10–15% of reproductive-aged women and is strongly associated with infertility and pelvic pain. Laparoscopic surgery plays an important role in the diagnosis and management of endometriosis. This study aimed to evaluate fertility outcomes following laparoscopic management of endometriosis.

Methods

This prospective study was conducted at Sudha Sundar Fertility Hospital, Tamil Nadu between January 2018 and August 2022. A total of 53 women diagnosed with endometriosis who underwent laparoscopic surgery were included. Procedures included laparoscopic cystectomy, adhesiolysis, and fulguration of endometriotic lesions. Patients were followed up for fertility outcomes.

Results

Most patients belonged to the age group of 31–35 years (43.3%). Primary infertility was present in 86.7% of patients. Advanced disease (stage III–IV) was observed in the majority of cases. The overall pregnancy rate following laparoscopic treatment was 45.29%.

Conclusions

Laparoscopic management of endometriosis improves fertility potential and assists in planning further assisted reproductive techniques when required. Metrics

References

Lee HJ, Lee JR, Kim SH, Kim SJ, Lee BS. Natural conception rate following laparoscopic surgery in infertile women with endometriosis. Clin Exp Reprod Med. 2013;40:63-8. DOI: https://doi.org/10.5653/cerm.2013.40.1.29 Sindan N, Hidayat R, Santoso B, Prasetyo A. Clinical factors influencing pregnancy outcome after laparoscopic treatment. Am J Transl Res. 2021;13:1234-40. Agarwal SK, Chapron C, Giudice LC, Laufer MR, Leyland N, Missmer SA, et al. Clinical diagnosis of endometriosis. Am J Obstet Gynecol. 2019;220:354.e1-12. DOI: https://doi.org/10.1016/j.ajog.2018.12.039 Kiesel L, Sourouni M. Diagnosis of endometriosis in the 21st century. Climacteric. 2019;22:296-302. DOI: https://doi.org/10.1080/13697137.2019.1578743 Dunselman GAJ, Vermeulen N, Becker C, Calhaz-Jorge C, D’Hooghe T, De Bie B, et al. ESHRE guideline: management of women with endometriosis. Hum Reprod. 2014;29:400-12. DOI: https://doi.org/10.1093/humrep/det457 Vercellini P, Vigano P, Somigliana E, Fedele L. Endometriosis: pathogenesis and treatment. Nat Rev Endocrinol 2014;10:261-75. DOI: https://doi.org/10.1038/nrendo.2013.255 Gunardi ER, Soetjiningsih S, Santoso B. Pregnancy outcome after laparoscopic cystectomy. Indones Obstet Gynecol. 2018;6:85-90. Lalani S, Choudhry AJ, Firth B, Bacal V, Walker M, Wen SW, et al. Endometriosis and adverse maternal outcomes. Hum Reprod 2018;33:1854-65. DOI: https://doi.org/10.1093/humrep/dey269 Maheux-Lacroix S, Nesbitt-Hawes E, Deans R, Abbott JA. Endometriosis fertility index predicts live births. Hum Reprod 2017;32:524-31. DOI: https://doi.org/10.1093/humrep/dex291 Marcoux S, Maheux R, Bérubé S; Canadian Collaborative Group on Endometriosis. Laparoscopic surgery in infertile women with minimal or mild endometriosis. N Engl J Med. 1997;337:217-22. DOI: https://doi.org/10.1056/NEJM199707243370401 Kennedy S, Bergqvist A, Chapron C, D’Hooghe T, Dunselman G, Greb R, et al. ESHRE guideline for diagnosis and treatment of endometriosis. Hum Reprod. 2005;20:2698-704. DOI: https://doi.org/10.1093/humrep/dei135 Practice Committee of American Society for Reproductive Medicine. Endometriosis and infertility. Fertil Steril. 2006;86:S156-60. DOI: https://doi.org/10.1016/j.fertnstert.2006.08.014 Dewailly D, Andersen CY, Balen A, Broekmans F, Dilaver N, Fanchin R, et al. Anti-Mullerian hormone in women. Hum Reprod Update. 2014;20:370-85. DOI: https://doi.org/10.1093/humupd/dmt062

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endometriosisinfertility

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