Fertility outcomes following laparoscopic management of endometriosis: a prospective study from a tertiary fertility centre
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20261277Keywords:
Endometriosis, Infertility, Laparoscopy, Pregnancy outcome, Endometriotic cystectomyAbstract
Background: Endometriosis is a common gynecological disorder affecting approximately 10–15% of reproductive-aged women and is strongly associated with infertility and pelvic pain. Laparoscopic surgery plays an important role in the diagnosis and management of endometriosis. This study aimed to evaluate fertility outcomes following laparoscopic management of endometriosis.
Methods: This prospective study was conducted at Sudha Sundar Fertility Hospital, Tamil Nadu between January 2018 and August 2022. A total of 53 women diagnosed with endometriosis who underwent laparoscopic surgery were included. Procedures included laparoscopic cystectomy, adhesiolysis, and fulguration of endometriotic lesions. Patients were followed up for fertility outcomes.
Results: Most patients belonged to the age group of 31–35 years (43.3%). Primary infertility was present in 86.7% of patients. Advanced disease (stage III–IV) was observed in the majority of cases. The overall pregnancy rate following laparoscopic treatment was 45.29%.
Conclusions: Laparoscopic management of endometriosis improves fertility potential and assists in planning further assisted reproductive techniques when required.
References
Lee HJ, Lee JR, Kim SH, Kim SJ, Lee BS. Natural conception rate following laparoscopic surgery in infertile women with endometriosis. Clin Exp Reprod Med. 2013;40:63-8.
Sindan N, Hidayat R, Santoso B, Prasetyo A. Clinical factors influencing pregnancy outcome after laparoscopic treatment. Am J Transl Res. 2021;13:1234-40.
Agarwal SK, Chapron C, Giudice LC, Laufer MR, Leyland N, Missmer SA, et al. Clinical diagnosis of endometriosis. Am J Obstet Gynecol. 2019;220:354.e1-12.
Kiesel L, Sourouni M. Diagnosis of endometriosis in the 21st century. Climacteric. 2019;22:296-302.
Dunselman GAJ, Vermeulen N, Becker C, Calhaz-Jorge C, D’Hooghe T, De Bie B, et al. ESHRE guideline: management of women with endometriosis. Hum Reprod. 2014;29:400-12.
Vercellini P, Vigano P, Somigliana E, Fedele L. Endometriosis: pathogenesis and treatment. Nat Rev Endocrinol 2014;10:261-75.
Gunardi ER, Soetjiningsih S, Santoso B. Pregnancy outcome after laparoscopic cystectomy. Indones Obstet Gynecol. 2018;6:85-90.
Lalani S, Choudhry AJ, Firth B, Bacal V, Walker M, Wen SW, et al. Endometriosis and adverse maternal outcomes. Hum Reprod 2018;33:1854-65.
Maheux-Lacroix S, Nesbitt-Hawes E, Deans R, Abbott JA. Endometriosis fertility index predicts live births. Hum Reprod 2017;32:524-31.
Marcoux S, Maheux R, Bérubé S; Canadian Collaborative Group on Endometriosis. Laparoscopic surgery in infertile women with minimal or mild endometriosis. N Engl J Med. 1997;337:217-22.
Kennedy S, Bergqvist A, Chapron C, D’Hooghe T, Dunselman G, Greb R, et al. ESHRE guideline for diagnosis and treatment of endometriosis. Hum Reprod. 2005;20:2698-704.
Practice Committee of American Society for Reproductive Medicine. Endometriosis and infertility. Fertil Steril. 2006;86:S156-60.
Dewailly D, Andersen CY, Balen A, Broekmans F, Dilaver N, Fanchin R, et al. Anti-Mullerian hormone in women. Hum Reprod Update. 2014;20:370-85.