Laparoscopic management of endometriosis in infertile women and outcome

Abstract

Background: The prevalence of endometriosis is estimated to be ~3% in womenof reproductive age and it is observedin 20 to 70% of patients presenting with infertility. For patientspresenting with moderate or severe endometriosis, the fertilityresults were better with surgical treatment than with no treatmentor with medical treatment. The objective of this study was to identify endometriosis in infertile women during diagnostic laparoscopy, to demonstrate the surgical feasibility and outcome of laparoscopic management of endometriosis in infertile women.

Methods: Endometriosis patients with infertility were analyzed. When operating on patients of endometriosis following aspects of surgery were correlated with pregnancy outcome. Endometrioma removal by cystectomy/ drainage and fulguration, conservation of ovarian tissue, restoration of tubo-ovarian relationship, adhesiolysis.

Results: There were 191 cases of infertility for which diagnostic laparoscopy were performed for the period of 2 years. Only 13 cases (6.8%) had features of moderate/severe endometriosis. 4 (30.76%) cases had severe and 9(69.24%) cases had moderate endometriosis. All cases were treated by laparoscopic surgery. 6 (47.04%) of them conceived. 5 (83.4%) of them conceived with IUI and one patient (16.6%) conceived with IVF treatment.

Conclusions: The use of laparoscopic surgery in the treatment of moderate/severe endometriosis improves success rates of IUI & IVF.