Outcome of Fertility after Radical Conservative Surgery in Grade III-IV Endometriosis Lesions: A Retrospective Analysis

Abstract

Purpose: Researching reproductive outcome after laparoscopic radical resection of grade III and IV endometrial lesions. Methods and Materials: A retrospective analysis of 54 women was carried out. The patients underwent laparoscopic radical resection in the Gynecology Department of a secondary health care center between January 2009 and December 2013. Diagnostic investigation, with histological confirmation of moderate to severe endometriosis, preceded surgical intervention in a multidisciplinary setting. Thirty seven of the 54 patients had an active desire for pregnancy. The outcome measure was the number of pregnancies in the subgroup of 37 women with an active desire for pregnancy. Results: Within the subgroup of 37 patients, 28 women became pregnant within the study period. Twelve patients became pregnant spontaneously and 16 had medically assisted pregnancies. Within the medically assisted group, 4 patients conceived after Intra-Uterine Insemination (IUI) and 12 after InVitro Fertilization (IVF). The pregnancy rate was 76%, a result similar to findings of earlier studies. Conclusion:The results of this retrospective analysis suggest that extensive laparoscopic surgery for moderate to severe endometriosis has a beneficial effect on fertility in both spontaneous and medically assisted pregnancies.