Laparoscopic management of endometriosis in infertile women and outcome

Latika Sahu, Anjali Tempe
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2013 · pp. 177–181 · doi:10.5455/2320-1770.ijrcog20130613 · W2107516549
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Laparoscopic management of moderate to severe endometriosis in infertile women showed a pregnancy success rate of 47% following surgical intervention.

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The study evaluated infertile women undergoing diagnostic laparoscopy over a two-year period to identify endometriosis and assess the feasibility and reproductive outcomes after laparoscopic management of moderate or severe disease. Among 191 infertility cases, only 13 (6.8%) showed features of moderate/severe endometriosis and all were treated laparoscopically with procedures including endometrioma removal (cystectomy or drainage/fulguration), ovarian tissue conservation, restoration of the tubo-ovarian relationship, and adhesiolysis. Overall, 6 of 13 patients (47.04%) conceived, with most conceptions occurring following IUI (83.4%) and one conception (16.6%) after IVF. A key limitation is the small number of moderate/severe cases (n=13) and the absence of a comparison group receiving no surgery or alternative treatments. This paper is centrally about endometriosis — it studies laparoscopic management of moderate/severe endometriosis in infertile women and related pregnancy outcomes.

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Abstract

Background: The prevalence of endometriosis is estimated to be ~3% in women of reproductive age and it is observedin 20 to 70% of patients presenting with infertility . For patientspresenting with moderate or severe endometriosis , the fertility results were better with surgical treatment than with no treatmentor with medical treatment. The objective of this study was to identify endometriosis in infertile women during diagnostic laparoscopy, to demonstrate the surgical feasibility and outcome of laparoscopic management of endometriosis in infertile women. Methods: Endometriosis patients with infertility were analyzed. When operating on patients of endometriosis following aspects of surgery were correlated with pregnancy outcome. Endometrioma removal by cystectomy/ drainage and fulguration, conservation of ovarian tissue, restoration of tubo-ovarian relationship, adhesiolysis. Results: There were 191 cases of infertility for which diagnostic laparoscopy were performed for the period of 2 years. Only 13 cases (6.8%) had features of moderate/severe endometriosis. 4 (30.76%) cases had severe and 9(69.24%) cases had moderate endometriosis. All cases were treated by laparoscopic surgery. 6 (47.04%) of them conceived. 5 (83.4%) of them conceived with IUI and one patient (16.6%) conceived with IVF treatment. Conclusions: The use of laparoscopic surgery in the treatment of moderate/severe endometriosis improves success rates of IUI & IVF.
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Keywords

Endometriosis, Laparoscopic surgery, InfertileAbstract

Background

The prevalence of endometriosis is estimated to be ~3% in womenof reproductive age and it is observedin 20 to 70% of patients presenting with infertility. For patientspresenting with moderate or severe endometriosis, the fertilityresults were better with surgical treatment than with no treatmentor with medical treatment. The objective of this study was to identify endometriosis in infertile women during diagnostic laparoscopy, to demonstrate the surgical feasibility and outcome of laparoscopic management of endometriosis in infertile women.

Methods

Endometriosis patients with infertility were analyzed. When operating on patients of endometriosis following aspects of surgery were correlated with pregnancy outcome. Endometrioma removal by cystectomy/ drainage and fulguration, conservation of ovarian tissue, restoration of tubo-ovarian relationship, adhesiolysis.

Results

There were 191 cases of infertility for which diagnostic laparoscopy were performed for the period of 2 years. Only 13 cases (6.8%) had features of moderate/severe endometriosis. 4 (30.76%) cases had severe and 9(69.24%) cases had moderate endometriosis. All cases were treated by laparoscopic surgery. 6 (47.04%) of them conceived. 5 (83.4%) of them conceived with IUI and one patient (16.6%) conceived with IVF treatment.

Conclusions

The use of laparoscopic surgery in the treatment of moderate/severe endometriosis improves success rates of IUI & IVF.

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Condition tags

endometriosisendometriomainfertility

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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