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by gemini-2.5-flash-lite, 2026-06-13
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This study found that unilateral versus bilateral adnexal disease in stage III and IV endometriosis did not significantly impact pregnancy, delivery, miscarriage, or ectopic rates following operative laparoscopy.
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by qwen3.7-flash, 2026-09-10
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This retrospective cohort study evaluated whether unilateral versus bilateral adnexal involvement affects pregnancy outcomes following operative laparoscopy for infertility in patients with stage III and IV endometriosis. The researchers analyzed data from 143 infertile women treated at a private fertility center in Michigan, comparing those with primarily unilateral disease to those with bilateral disease over a two-year follow-up period. Results indicated no significant differences between the two groups regarding pregnancy rates, delivery rates, miscarriage rates, or ectopic pregnancy rates, suggesting that the extent of adnexal involvement does not influence these specific outcomes after surgical intervention. This paper is centrally about endometriosis — specifically examining how the laterality of adnexal disease impacts fertility outcomes after conservative surgery for advanced stages.
Abstract
Laparoscopy is the gold standard of conservative surgical treatment of infertility patients with endometriosis. Previous studies have shown improvement in fecundity rate and cumulative conception rate (CCR) after laparoscopic surgical treatment of infertile patients with early and advanced stages of endometriosis. However, none of these studies have compared the effect of unilateral versus bilateral adnexal involvement on the likelihood of achieving pregnancy after surgical treatment of advanced endometriosis. This retrospective historical cohort study evaluated the effect of unilateral versus bilateral adnexal involvement on the pregnancy rate after operative laparoscopy for infertile patients with advanced stages of endometriosis. The study subjects were 143 patients with stage III and stage IV endometriosis undergoing operative laparoscopy for infertility treatment who had primarily unilateral (n = 43, group 1) or bilateral adnexal disease (n = 100, group 2). The mean duration of infertility was 3.4 ± 2.7 years. The study was carried out at a private fertility center in Michigan. The participants were followed for up to 2 years. No significant difference was found between the unilateral and bilateral groups in pregnancy rates (28% vs. 31%), delivery rates (21% vs. 23%), miscarriage rates (25% vs. 13%), or ectopic rates (0% vs. 13%). The use of spontaneous and intrauterine insemination after surgery achieved a CCR of 59% and 49% for the unilateral group and bilateral group, respectively. These findings suggest that conservative laparoscopic surgery for advanced stages of endometriosis is an effective treatment modality to enhance the likelihood of pregnancy in infertile patients. There seems to be no difference between unilateral or bilateral adnexal involvement on the pregnancy or delivery rates and other pregnancy outcomes.
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Unilateral Versus Bilateral Adnexal Disease in Stage III and Stage IV Endometriosis Does Not Affect Pregnancy Outcome After Operative Laparoscopy
- Mostafa Abuzeid
- Abeer Ahmed
- Khaled Sakhel
- Riham Alwan
- Mohammad Ashraf
- Mohammed Mitwally
- Michael Diamond
Laparoscopy is the gold standard of conservative surgical treatment of infertility patients with endometriosis. Previous studies have shown improvement in fecundity rate and cumulative conception rate (CCR) after laparoscopic surgical treatment of infertile patients with early and advanced stages of endometriosis. However, none of these studies have compared the effect of unilateral versus bilateral adnexal involvement on the likelihood of achieving pregnancy after surgical treatment of advanced endometriosis. This retrospective historical cohort study evaluated the effect of unilateral versus bilateral adnexal involvement on the pregnancy rate after operative laparoscopy for infertile patients with advanced stages of endometriosis. The study subjects were 143 patients with stage III and stage IV endometriosis undergoing operative laparoscopy for infertility treatment who had primarily unilateral (n = 43, group 1) or bilateral adnexal disease (n = 100, group 2). The mean duration of infertility was 3.4 ± 2.7 years. The study was carried out at a private fertility center in Michigan. The participants were followed for up to 2 years.
No significant difference was found between the unilateral and bilateral groups in pregnancy rates (28% vs. 31%), delivery rates (21% vs. 23%), miscarriage rates (25% vs. 13%), or ectopic rates (0% vs. 13%). The use of spontaneous and intrauterine insemination after surgery achieved a CCR of 59% and 49% for the unilateral group and bilateral group, respectively.
These findings suggest that conservative laparoscopic surgery for advanced stages of endometriosis is an effective treatment modality to enhance the likelihood of pregnancy in infertile patients. There seems to be no difference between unilateral or bilateral adnexal involvement on the pregnancy or delivery rates and other pregnancy outcomes.
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