Determinant factors of fertility outcomes after laparoscopic colorectal resection for endometriosis.
OBJECTIVE
The aims of this prospective study were to evaluate fertility, pregnancy outcomes and their determinant factors after laparoscopic segmental colorectal resection for endometriosis.


METHODS
We studied 83 women who underwent colorectal resection for endometriosis. Thirty-nine women (47%) had an associated infertility and 51 (61.4%) wished to conceive after surgery. Surgical route was exclusive laparoscopy in 77 cases (92.7%) and laparoconversion in 6 (7.3%).


RESULTS
Twenty-nine pregnancies were obtained in 24 patients (43.6%) including 20 spontaneous (69%) and 9 by IVF (31%). The median time to conceive spontaneously was 6 months and 20 months by IVF. Among the 39 infertile women, 18 (46%) conceived during the study period. A relation was found between pregnancy rate and patient age (p=0.02). Reduction in pregnancy rate was correlated to the presence of adenomyosis (p=0.04) and high ASRM total score (p<0.001) as well as exclusive laparoscopy compared to conversion to laparotomy for colorectal resection (p=0.01).


CONCLUSIONS
Adenomyosis and conversion to laparotomy as well as patient age, ASRM score appeared determinant factors of fertility outcome.
Daraï
Emile
E
Service de Gynécologie-Obstétrique, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Université Pierre et Marie Curie Paris 6, 4 rue de la Chine, 75020 Paris, France. emile.darai@tnn.aphp.fr
Carbonnel
Marie
M
Dubernard
Gil
G
Lavoué
Vincent
V
Coutant
Charles
C
Bazot
Marc
M
Ballester
Marcos
M
D000328:Adult; D000367:Age Factors; D003106:Colon / Q000601:surgery; D004715:Endometriosis / Q000601:surgery*; D005260:Female; D005298:Fertility; D005307:Fertilization in Vitro; D006801:Humans; D007247:Infertility, Female / Q000601:surgery; D010535:Laparoscopy; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D011446:Prospective Studies; D012007:Rectum / Q000601:surgery