[Colorectal endometriosis and fertility].
Endometriosis is a common gynaecological condition affecting 10 to 15% of the female population. Deep infiltrating endometriosis (DIE) is diagnosed in 20% of women with endometriosis. Moreover, bowel endometriosis is found in five to 12% of patients with endometriosis. Colorectum represents 90% of all bowel locations. For women with infertility associated with colorectal endometriosis, no predictive criteria of fertility outcome are available. In a literature review, the pregnancy rate after colorectal resection reached 63%. These results, particularly high, raise the issue on legitimacy of colorectal resection in infertile women. Recent studies suggest that predictive criteria of success after colorectal resection are; a young age; a low American Society of Reproductive Medicine (ASRM) score and the laparoscopic route. In contrast, the presence of adenomyosis appears a negative predictive factor of fertility outcome. Despite encouraging results on the fertility of colorectal resection for endometriosis, only studies comparing the results of assisted reproductive therapy to those of surgery are required to identify good candidates for surgery.
Daraï
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Service de gynécologie-obstétrique, université Pierre-et-Marie-Curie-Paris-6, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France. emile.darai@tnn.aphp.fr
Bazot
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Rouzier
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Coutant
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Ballester
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D003108:Colonic Diseases / Q000601:surgery*; D003107:Colorectal Surgery / Q000009:adverse effects / Q000379:methods*; D004715:Endometriosis / Q000601:surgery*; D005260:Female; D005298:Fertility / Q000502:physiology*; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D012002:Rectal Diseases / Q000601:surgery*; D016896:Treatment Outcome