Laparoscopic treatment of bowel endometriosis in infertile women.
BACKGROUND
The purpose of the study was to determine the influence of bowel endometriosis on fertility, and to study whether its removal improves fecundity in women with endometriosis-associated infertility.


METHODS
Three groups of infertile patients were included in the study. Group A (60 women) consisted of patients who underwent surgery for endometriosis with colorectal segmental resection. In group B, 40 patients with evidence of bowel endometriosis underwent endometriosis removal without bowel resection. Group C consisted of 55 women who underwent surgery for moderate or severe endometriosis with at least one endometrioma and deep infiltrating endometriosis but without bowel involvement. The women were clinically evaluated before laparoscopy and then at 1 month, at 6 months and at each year up to 4 years after surgery. Main outcome measures were surgical complications as well as post-operative pregnancy rate, time to conception and monthly fecundity rate.


RESULTS
The monthly fecundity rates (MFR) in groups A, B and C were 2.3, 0.84 and 3.95%, respectively. The difference in the MFR between groups was significant (P < 0.05).


CONCLUSIONS
The presence of bowel infiltration by endometriosis seems to negatively influence the reproductive outcome in women with endometriosis-associated infertility. The complete removal of endometriosis with bowel segmental resection seems to offer better results in terms of post-operative fertility.
Stepniewska
A
A
Departments of Obstetrics and Gynecology, Ospedale Sacro Cuore, Via Don Sempreboni 5, Negrar 37024, Verona, Italy. annastep@infinito.it
Pomini
P
P
Bruni
F
F
Mereu
L
L
Ruffo
G
G
Ceccaroni
M
M
Scioscia
M
M
Guerriero
M
M
Minelli
L
L
D004715:Endometriosis / Q000150:complications / Q000601:surgery*; D005260:Female; D005298:Fertility; D005500:Follow-Up Studies; D006801:Humans; D007247:Infertility, Female / Q000150:complications / Q000601:surgery*; D007248:Infertility, Male; D007422:Intestines / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome