Reproductive Outcome After Surgical Treatment of Endometriosis – Retrospective Analytical Study

Abstract

Objective: The aim of the study was to investigate the reproductive outcomes of patients after surgical treatment of endometriosis. Material and Methods: The study included 100 infertile women, aged 21 to 41 years, who underwent surgical treatment of endometriosis. From January 2007 to January 2012, excision of endometriosis was performed by operative laparoscopy or laparotomy. Demographic, clinical, surgical and reproductive outcomes of 52 patients were retrospectively analyzed. Result: Twenty-three pregnancies (44%) were obtained in 52 patients, resulting in 16 term pregnancies, 4 spontaneous abortions under 16 weeks gestation, 2 spontaneous abortions at 20 gestational weeks and 1 ectopic pregnancy. Twenty nine patients did not achieve pregnancy and 68.9% (20/29) of them were treated with IVFICSI. Spontaneous pregnancies were obtained within 7 months after the surgery, whereas IVF-ICSI pregnancies were obtained within the period of 11 months. Seven patients were stage I, 14 patients stage II, 19 patients stage III, and 12 patients stage IV according to the American Fertility Society (AFS) Classification of Endometriosis. The pregnancy rate was 57% in stages I-II, 47% in stage III, 16% in stage IV endometriosis; and the rate of term pregnancies was 83%, 66%, and 0%, respectively. Seven pregnancies (7/14) were obtained in patients with bilateral endometriosis and 5 of them resulted in term pregnancy. Sixteen pregnancies (16/38) were obtained in patients with unilateral endometriosis and 11 of them resulted in term pregnancy. Conclusion: After surgical treatment of endometriosis, the pregnancy and live birth rates seem to be improved. Reproductive outcome is closely associated with the AFS score. Bilaterality of endometriosis does not affect pregnancy outcome.