Etiological Study on Postoperative Infertility in Endometriosis Patients

Objective: To look into the reasons of postoperative infertility in the infertile patients with endometriosis treated by laparoscopic operation (LO) or abdominal operation (AO). Methods: 103 infertile subjects with endometriosis were selected and divided into two groups for either LO or AO treatment. After operation, all patients took Gestrinone for 3-6 months and were followed-up for two years. For those cases with postoperative infertility, the etiological factors were analyzed. Results: During the first two years after operation, the total gravid rate was 52.74% in these 103 patients. The gravid rate was 55.20% in LO group and 50.00% in AO group, which had no significant difference between them (P0.05); there was no close association between fallopian impediment and rAFS staging of endometriosis (P0.05). Among those patients with postoperative infertility, 37.21% (16/43) of them were caused by the fallopian impediment; 13.95% (6/43) by uterus adenomyosis, 9.30% (4/43) by recurrence of endometriosis, 6.98% (3/43) by uterus myoma, 4.65% (2/43) by two times of trans-abdominal operation, and in addition, 27.91% (12/43) by unclear reasons but with unobstructed fallopian tubes. Conclusions: The operative therapy should be chosen for infertile patients with endometriosis and LO to be the first choice if it is available. The fallopian impediment is the most important cause for the postoperative infertility. Other reasons include recurrent endometriosis companied with uterus myoma, adenomyosis, etc.