Laparoscopic surgery for endometriosis-associated infertility: a pathophysiologic approach

Pahlajani, Geetu; Falcone, Tommaso

doi:10.1007/s10397-010-0564-5

Cited by 4 publications

(3 citation statements)

References 105 publications

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“…[17] Unfortunately, being an invasive procedure, laparoscopy is associated with rare but significant potential risks. [20] While it is not feasible for all infertile women to undergo laparoscopic diagnosis. A lack of proven noninvasive diagnostic methods has hindered the ability of clinicians to choose appropriate treatment, including surgery.…”

Section: Discussionmentioning

confidence: 99%

Combination of noninvasive methods in diagnosis of infertile women with minimal or mild endometriosis, a retrospective study in China

et al. 2019

Medicine

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This study means to investigate a combination of noninvasive methods in diagnosis of minimal or mild endometriosis expecting to narrow down the range of laparoscopic exploration for female infertility. It is a retrospective case control study of totally 447 patients suspected unexplained infertility before surgery were eligible from May 2012 to February 2017. Of these, 299 patients were laparoscopy-proved minimal or mild endometriosis group, the remaining 148 patients served as control group (normal pelvis). Preoperative age, duration of infertility, type of infertility, body mass index, baseline follicle-stimulating hormone, anti- Müllerian hormone, serum CA 125 , clinical symptoms, findings on vagino-recto-abdominal examinations and pregnancy prognosis had been recorded. Every variable and their combinations were evaluated. Any single factor had limited diagnostic value. The cut-off value for CA 125 was 19.25 IU/L. Parallel testing had a higher sensitivity at 81.3%. Serial tests of vagino-recto-abdominal examination combined with dysmenorrhea or positive CA 125 got reasonable sensitivity (51.4% and 49%), remarkable high specificities (95.7% and100%) and Positive Predictive Value (96.4% and 100%). Multivariate logistic regression identified the following factors in decreasing order of importance: (1) vagino-recto-abdominal examinations, (2) CA 125 , (3) dysmenorrhea, their ORs being 16.148, 3.796, and 2.809, respectively. The spontaneous pregnancy rate (50.8%) in minimal or mild endometriosis was higher than control (35.6%, P = .043). A combination of noninvasive diagnostic methods had certain preoperative diagnostic value of minimal or mild endometriosis, which might benefit some patients from avoiding laparoscopic surgery.

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Section: Discussionmentioning

confidence: 99%

Combination of noninvasive methods in diagnosis of infertile women with minimal or mild endometriosis, a retrospective study in China

et al. 2019

Medicine

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“…Abnormalities of this fluid affect gametes, embryos and tubal functions. The occurrence of pelvic adhesion plays an important role in infertility through the mechanism of disruption of ovum interruption, transport of sperm to cavity peritonei and inhibit tubal pickup oocyst, tubal motility, and tubal patency [1,6,7].…”

Section: Table3 the Correlation Between Infertility Causes With The mentioning

confidence: 99%

The Outcomes of Invitro Fertilization and Embryo Transfer in Endometriosis-Associated Infertility: A Case Control Study

Wahyuni¹

2019

Proceedings of the Third International Conference on Sustainable Innovation 2019 – Health Science and Nursing (IcoSIHSN 2019)

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The pathophysiology of infertility in endometriosis is still controversial and widely investigated. Several mechanisms are put forward. Whether In Vitro Fertilization-Embryo Transfer (IVF-ET) program in endometriosis is a solution to improve the fertility still needs further studied. Objective : To compare the output of IVF-ET between endometriosis infertility and that of non-endometriosis infertility. Methods : This research is non experimental research with case control design. A retrospective approach with secondary data was conducted in 2017. The samples are fifty endometrial infertility patients and fifty infertility tubal factor and or sperm undergoing IVF-ET program at Permata Hati Clinic, Dr. Sardjito Hospital Yogyakarta. Results : The research output is fertilization rate, i.e. a number of good quality embryo and the success of pregnancy based on pregnancy test. Data analysis was done by statistical test of T test and Chi Square. Multivariate analysis was done by logistic regression. Characteristics of both study groups are similar: in terms of age, BMI, duration of infertility, basal FSH, basal E2, stimulation type and gonadotropin needs. A number of good quality embryos in endometriosis group is lower (2.34 ± 2.33 vs 3.44 ± 2.97; p <0.039), but the fertilization rate is the same (48.58 ± 27.16 vs 55.19 ± 30.9; p > 0.259). Compared to non-endometriosis, endometriosis group has bigger risk of pregnancy failure (OR 3.758; CI95% 1.11-12.68; p <0.03). Conclusion : There is no difference in fertilization rates between endometriosis and non-endometriosis. The number of good quality embryo on endometriosis group is lower than non-endometriosis. Pregnancy failure on endometriosis group is higher than non-endometriosis group.

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“…They harm oocyte development, tubal transport, impaired folliculogenesis, impaired follicular steroidogenesis, embryonic development, and cytokines and prostaglandins ultimately affecting the embryo's development. As a result, the implantation process is sped up, resulting in lower implantation and pregnancy rates (Jørgensen et al, 2017;Pahlajani & Falcone, 2010). The reason for decreased implantation rate is still unknown, but it involves some parameters, including the egg and embryo quality.…”

Section: Introductionmentioning

confidence: 99%

Gonadotropin Stimulation's Effects on Folliculogenesis in Mild and Severe Endometriosis

Wahyuni,

Verifianto

2023

ijebss

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Infertility in endometriosis has been linked to a number of theories, including a disruption in the folliculogenesis process. Further research is needed to determine whether this issue is linked to the stage of endometriosis or gonadotropin stimulation. In a cross-sectional study design, the study comprised 28 women with moderate endometriosis and 25 women with severe endometriosis who had had in vitro fertilization. The data includes the total number of follicles, mature follicles, and ovarian responses. Bivariate and multivariate analysis were used to examine the data. In bivariate analysis, the t-test and chi-square were utilized. There was no significantly difference in number of follicles total between the two groups (15.2 vs. 10.6; p>0,05). In comparison to the severe endometriosis group, the moderate endometriosis group had considerably more mature follicles (2.891.62 vs. 1.761.17; p0,05).In the severe endometriosis group, insufficient ovarian response was more likely (RR 1.26 ; p 0.018). The number of follicles in total is the same in mild and severe endometriosis, but mild endometriosis has more developed follicles, and severe endometriosis has a higher rate of inadequate ovarian response

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Laparoscopic surgery for endometriosis-associated infertility: a pathophysiologic approach

Cited by 4 publications

References 105 publications

Combination of noninvasive methods in diagnosis of infertile women with minimal or mild endometriosis, a retrospective study in China

Combination of noninvasive methods in diagnosis of infertile women with minimal or mild endometriosis, a retrospective study in China

The Outcomes of Invitro Fertilization and Embryo Transfer in Endometriosis-Associated Infertility: A Case Control Study

Gonadotropin Stimulation's Effects on Folliculogenesis in Mild and Severe Endometriosis

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