The second time around: reproductive performance after repetitive versus primary surgery for endometriosis.
After repetitive surgery for recurrent endometriosis, 20 of 89 (22%) women achieved spontaneous pregnancy, compared with 165 of 411 (40%) after first-line procedure (adjusted incidence rate ratio, 0.51; 95% confidence interval, 0.32 to 0.82), and the 12- and 24-month cumulative pregnancy rates were 14% and 26% in the former group compared with 32% and 38% in the latter. Among infertile patients at baseline, 13 of 67 (19%) conceived after reoperation compared with 98 of 290 (34%) after primary surgery (adjusted incidence rate ratio, 0.55; 95% confidence interval, 0.30 to 0.99), and the 12- and 24-month cumulative pregnancy rates were 13% and 22% in the former group and 25% and 30% in the latter.
Vercellini
Paolo
P
Division of Gynecologic Surgery, Istituto Ostetrico e Ginecologico "Luigi Mangiagalli," Università degli Studi di Milano, Milan, Italy. Electronic address: paolo.vercellini@unimi.it.
Somigliana
Edgardo
E
Infertility Unit, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milan, Italy.
Daguati
Raffaella
R
Infertility Unit, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milan, Italy.
Barbara
Giussy
G
Division of Gynecologic Surgery, Istituto Ostetrico e Ginecologico "Luigi Mangiagalli," Università degli Studi di Milano, Milan, Italy.
Abbiati
Annalisa
A
Division of Gynecologic Surgery, Istituto Ostetrico e Ginecologico "Luigi Mangiagalli," Università degli Studi di Milano, Milan, Italy.
Fedele
Luigi
L
Division of Gynecologic Surgery, Istituto Ostetrico e Ginecologico "Luigi Mangiagalli," Università degli Studi di Milano, Milan, Italy.
D000328:Adult; D015331:Cohort Studies; D004715:Endometriosis / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D007247:Infertility, Female / Q000453:epidemiology / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology; D011247:Pregnancy; D018873:Pregnancy Rate; D012008:Recurrence; D016896:Treatment Outcome; D014591:Uterine Diseases / Q000150:complications / Q000453:epidemiology / Q000601:surgery*