Clinical analysis on conservative surgery for severe endometriosis-associated infertility in 127 cases

Objective:To compare the clinical effects of laparoscopy and laparotomy on severe endometriosis-associated infertility,evaluate the value of drug therapy after surgery,explore the appropriate time to regain fertility.Methods:Clinical data of 127 cases with severe endometriosis-associated infertility were analysed retrospectively and followed up 12 months after operation,including 59 cases undergoing laparoscopy(laparoscopy group) and 68 cases undergoing laparotomy(laparotomy group).The advantages and effects of laparoscopy and laparotomy were compared after 12 months.Results:Operating time,fever rate,anus gas discharge 24 hours rate after surgery,the hospital stay time and recovery time in laparoscopy group were shorter than those in laparotomy group(P0.001);there was no significant difference in ameliorated dysmenorrhea,recurrence rate and pregnancy rate after 1 year between laparoscopy group and laparotomy group(P0.05).Pregnancy rate during 1~6 months after surgery was higher than that during 7~12 months after surgery(P0.05).Recurrence rate of 56 cases treated with GnRHa therapy after surgery was lower than that without GnRHa therapy(P0.05),but there was no significant difference in regnancy rate between cases with GnRHa therapy and cases without GnRHa therapy(P0.05).Conclusion:Laparoscopy in the treatment of severe endometriomas is currently preferred surgical procedure and can replace laparotomy.It is also safe and feasible for severe endometriosis.Conservative operation can improve pregnancy rate,patients would more likely have pregnancy within 6 months after surgery.For severe endometriosis,combined GnRHa therapy with surgery can decrease occurrence.