Spontaneous viable birth in a case of stage III pelvic endometriosis with bilateral tubal damage following diagnostic intervention: who deserves the credit?

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A 30-year-old woman with stage III pelvic endometriosis and bilateral tubal damage spontaneously conceived and delivered a healthy baby after being advised to undergo IVF.

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This paper reports a single case of a 30-year-old woman with primary infertility who was diagnosed on diagnostic laparoscopy and chromotubation with stage III pelvic endometriosis, extensive pelvic anatomic distortion, and bilateral tubal blockage. After being advised to pursue in vitro fertilization, she instead conceived spontaneously and delivered a healthy term infant by cesarean section. The authors note that spontaneous conception rates in advanced endometriosis are often considered nearly zero and state that expectant management is therefore not recommended for associated infertility, while acknowledging the major caveat that this is an isolated case. This paper is centrally about endometriosis — it describes spontaneous viable birth in a woman with stage III pelvic endometriosis and bilateral tubal damage.

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Abstract

IntroductionWe are reporting a case of spontaneous conception and viable birth in a woman diagnosed with stage III pelvic endometriosis and bilateral tubal blockade.CaseA 30-year-old woman was investigated for primary infertility and was diagnosed with stage III pelvic endometriosis, extensive distortion of pelvic anatomy and bilateral tubal damage on diagnostic laparoscopy and chromotubation. Patient was advised in vitro fertilization; however, she chose otherwise and conceived spontaneously, delivering a healthy baby by cesarean section at term.DiscussionSpontaneous conception rates amongst women with advanced endometriosis nearly approaches zero; hence, expectant management is not recommended for associated infertility. Despite being and isolated case, this report raises questions regarding the association of infertility even with advanced endometriosis and also highlights the beneficial effect pregnancy has on endometriosis.
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Abstract

Introduction We are reporting a case of spontaneous conception and viable birth in a woman diagnosed with stage III pelvic endometriosis and bilateral tubal blockade. Case A 30-year-old woman was investigated for primary infertility and was diagnosed with stage III pelvic endometriosis, extensive distortion of pelvic anatomy and bilateral tubal damage on diagnostic laparoscopy and chromotubation. Patient was advised in vitro fertilization; however, she chose otherwise and conceived spontaneously, delivering a healthy baby by cesarean section at term.

Discussion

Spontaneous conception rates amongst women with advanced endometriosis nearly approaches zero; hence, expectant management is not recommended for associated infertility. Despite being and isolated case, this report raises questions regarding the association of infertility even with advanced endometriosis and also highlights the beneficial effect pregnancy has on endometriosis. Similar content being viewed by others

References

Holoch KJ, Lessey BA (2010) Endometriosis and infertility. Clin Obstet Gynecol 53:429–438 Endometriosis and Infertility: A Committee Opinion (2012) The Practice Committee of the American Society for Reproductive Medicine Birmingham, Alabama. Fertil Steril 98(3):591–598 Olive DL, Stohs GF, Metzger DA, Franklin RR (1985) Expectant management and hydrotubations in the treatment of endometriosis associated infertility. Fertil Steril 44:35–41 Missmer SA, Hankinson SE, Spiegelman D, Barbieri RL, Marshall LM, Hunter DJ (2004) Incidence of laparoscopically confirmed endometriosis by demographic, anthropometric and lifestyle factors. Am J Epidemiol 160:784–796 The Practice Committee of the American Society for Reproductive Medicine (2004) Endometriosis and infertility. Fertil Steril 81:1441–1446 Marcoux S, Maheux R, Berube S (1997) Laparoscopic surgery in infertile women with minimal or mild endometriosis. Canadian Collaborative Group on Endometriosis. N Engl J Med 337:217–222 Parazzini F (1999) Ablation of lesions or no treatment in minimal-mild endometriosis in infertile women: a randomized trial. Gruppo Italiano per lo Studio dell Endometriosis. Hum Reprod 14:1332–1334 Conflict of interest I hereby state that we have no conflict of interests to declare. Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Shekhar, S., Sharma, C. & Singh, K. Spontaneous viable birth in a case of stage III pelvic endometriosis with bilateral tubal damage following diagnostic intervention: who deserves the credit?. Arch Gynecol Obstet 287, 473–475 (2013). https://doi.org/10.1007/s00404-012-2598-6 Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s00404-012-2598-6

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Fallopian Tube Diseases Fertilization Infertility, Female Adult Endometriosis Endometriosis Fallopian Tube Diseases Fallopian Tube Diseases Female Humans Infant, Newborn Infertility, Female Pelvis Pregnancy

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References (7)

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