Reproductive aspects in the treatment of colorectal endometriosis

K.V. Krasnopolskaya, I.Yu. Ershova, K.M. Isakova, V.V. Troshina
In: Russian Journal of Human Reproduction · 2024 · vol. 30(6) , pp. 140 · doi:10.17116/repro202430061140 · W4405869509
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⚙ AI-generated summary by claude@2026-06, 2026-06-10 ⓘ

This study found that in vitro fertilization is most effective for colorectal endometriosis patients when performed before surgery or within six months after, recommending oocyte/embryo banking for those with delayed reproductive plans due to high recurrence rates.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 ⓘ

The paper studied reproductive outcomes of IVF for infertility in 96 women aged 24–35 with verified colorectal deep infiltrating endometriosis (CRDE), comparing IVF begun before surgery versus after surgery and, among post-surgical patients, whether IVF was started within 6 months (“urgent”) or after >6 months (“delayed”). Using AMH to stratify ovarian reserve and reporting pregnancy rates per stimulated cycle and embryo transfer, the authors found that IVF effectiveness in the pre-surgical group was comparable to general Russian IVF population figures, and that urgent post-surgical IVF showed no statistically significant decline versus the pre-surgical group, whereas delayed IVF had significantly lower pregnancy rates. A key limitation explicitly implied by the study design is the retrospective/observational grouping based on when IVF was started, including heterogeneous patient intentions (e.g., delayed desire for pregnancy) that may confound comparisons. This paper is centrally about endometriosis — specifically reproductive aspects and timing of IVF in colorectal deep infiltrating endometriosis.

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Abstract

Objectives. To compare the effectiveness of in vitro fertilization (IVF) as first and second line treatment for infertility in colorectal endometriosis. As well as gather evidence to support the validity for own oocyte/embryo banking before to surgical intervention in women with concomitant endometriotic ovarian cysts. Material and methods. Frequency pregnancy rates per ovarian stimulation and embryo transfer were evaluated in 96 infertile patients with colorectal endometriosis. The analysis of the IVF outcome was carried out depending on the timing of the operation performed. The results obtained were compared with the ovarian reserve (AMH level) and the presence of concomitant pathologies: endometrioid ovarian cysts and endometrial hyperplasia. Results. A veraciously decreasing marks in ovarian stimulation and embryo transfer was observed when IVF was initiated more than 6 months after surgical treatment for colorectal endometriosis. The observed correlation of poor ovarian response may be explained by a decrease in ovarian reserve and a higher incidence of endometrial hyperplasia late postoperatively. The majority of women were found to have endometrioid ovarian cysts again, which often required re-excision of the cyst due to persistent recurrence after surgical treatment of colorectal endometriosis. Conclusion. Based on these findings, in infertile women with colorectal endometriosis it is preferable to perform IVF either before surgical treatment or within a short timeframe (not surpassing 6 months) after surgery. In cases where the realization of reproductive plans is delayed, it is advisable to recommend oocyte/embryo banking due to the high likelihood of recurrent endometriosis and decrease associated ovarian reserve.

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endometriosisinfertility

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