Recurrences and fertility after endometrioma ablation in women with and without colorectal endometriosis: a prospective cohort study†

Horace Roman, Solène Quibel, Mathieu Auber, M. Auber, Hélène Muszynski, Emmanuel Huet, Loı̈c Marpeau, Loïc Marpeau, Jean‐Jacques Tuech, Jean Jacques Tuech
Human Reproduction · 2015 · vol. 30(3) , pp. 558–568 · doi:10.1093/humrep/deu354 · PMID:25574030 · W2167885274
article OA: bronze CC0 ⤵ 59 in-corpus citations
📄 Open PDF View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

Concomitant management of colorectal endometriosis does not impact endometrioma recurrence or pregnancy rates following plasma energy ablation in women with ovarian endometriomas.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

Abstract

STUDY QUESTION: What are the recurrence and pregnancy rates in women managed for ovarian endometrioma by ablation using plasma energy with and without associated surgery for colorectal endometriosis? SUMMARY ANSWER: Concomitant management of colorectal endometriosis does not impact either risk of recurrences or probability of pregnancy in women managed for endometrioma ablation using plasma energy. WHAT IS KNOWN ALREADY: No consensus exists on how best to manage patients presenting with ovarian endometriomas and colorectal endometriosis, in terms of impact on fertility preservation and recurrence rates. STUDY DESIGN, SIZE, DURATION: A prospective series of consecutive patients managed for ovarian endometriomas by ablation using plasma energy, over a period of 48 consecutive months. The study included patients with associated colorectal endometriosis (n = 52) and those who were free of colorectal localizations of the disease (n = 72). No women were lost to follow-up. PARTICIPANTS/MATERIALS, SETTING, METHODS: The 124 women included in this study were managed for either unilateral or bilateral ovarian endometriomas using plasma energy at a university tertiary care center. Recurrences and pregnancy rate were compared in patients with and without colorectal endometriosis. The minimum length of follow-up was 1 year. Cyst recurrences were assessed using pelvic ultrasound and magnetic resonance imaging. Kaplan-Meier and actuarial life-table analysis were used to estimate the recurrence-free survival curve and the probability of pregnancy. The Cox model was used to assess independent predictive factors for recurrences. Pregnancy likelihood and independent predictors were estimated using a regression logistic model. MAIN RESULTS AND THE ROLE OF CHANCE: Mean follow-up was 32 ± 18 months. Forty-eight patients (40.3%) were presumed infertile and attended an assisted reproductive techniques (ART) center. Eighteen patients presented with a recurrence (14.5%). Bilateral localization of endometriomas was the only factor independently related to an increased risk of recurrences [hazard ratio 3.3, 95% confidence interval (CI) 1.2-9.4]. Of the 83 women wishing to conceive (66.9%), 51 became pregnant (61.4%) and 33 of these pregnancies were spontaneous (64.7%). The rates of pregnancy were 65.8% for the group of patients with associated colorectal endometriosis and 57.8% for controls (P = 0.50). Age over 35 years was the only independent factor for which association with pregnancy rates approached the significance threshold (adjusted odds ratio 0.35, 95% CI 0.12-1, P = 0.06). LIMITATIONS, REASONS FOR CAUTION: The study sample size may be insufficient to reveal statistically significant differences related to risk factors which have low impact on the probability of recurrence and pregnancy. Data on ovarian reserve before and after the procedure was not available in all patients, which would have added to our results and the discussion about treatment of endometrioma in general. WIDER IMPLICATIONS OF THE FINDINGS: Concomitant management of colorectal endometriosis does not impact either risk of recurrences or the probability of pregnancy in women having benefited from ovarian endometrioma ablation using plasma energy. Moreover, surgical management of colorectal and ovarian endometriosis may allow spontaneous conception in one out of three patients, thus reducing expenses related to ART management. STUDY FUNDING/COMPETING INTERESTS: No financial support was received for this study. Horace Roman reports personal fees for participating in a symposium and masterclass presenting his experience in the use of PlasmaJet.

My notes (saved in your browser only)

Condition tags

endometriosisendometrioma

MeSH descriptors

Endometriosis Fertility Adult Colonic Diseases Colonic Diseases Colonic Diseases Endometrial Ablation Techniques Endometrial Ablation Techniques Endometriosis Endometriosis Female Fertility Preservation Humans Kaplan-Meier Estimate Logistic Models Pregnancy Pregnancy Rate Prospective Studies Rectal Diseases Rectal Diseases

Citation neighborhood

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.

References (20)

Cited by (50)

Source provenance

europepmc
last seen: 2026-06-12T06:13:51.797165+00:00
openalex
last seen: 2026-06-10T17:14:06.276822+00:00
pubmed
last seen: 2026-05-13T22:18:04.362919+00:00
License: CC0 · commercial use OK