title: Focusing on surgery results in infertile patients with deep endometriosis.
abstract: Infertility is a common problem in patients with endometriosis and the involved mechanisms are still not completely known. The management of infertility in endometriosis patients includes surgery as well as assisted reproductive technology. Laparoscopic surgery has shown better results in infertility patients with endometriosis in comparison to laparotomy procedures. Laparoscopic surgery has proposed benefits in both minimal to moderate diseases. However, while there may be some benefits with severe diseases, there is still not enough evidence to recommend laparoscopic surgery as the recommended surgery when the main goal is to obtain fertility. We performed a MEDLINE search for articles on fertility in women with deep infiltrating endometriosis (DIE) published between 1990 and April 2015 using the following keywords: "endometriosis", "deep infiltrative endometriosis", "infertility", "fertility after surgery", "laparoscopy surgery", "laparotomy", "pregnancy", "fertility outcome", "bladder endometriosis", and "ureteral endometriosis". The aim of this review was to analyze the results of available clinical studies (randomized controlled or not controlled studies; retrospective cohort studies; or case-control and prospective studies) and guidelines on surgical treatment of infertile endometriosis patients, and pregnancy outcomes after surgery.
authors.affiliation: a Division of Gynecology and Obstetrics, Department of Surgical Sciences , University of Cagliari , Cagliari , Italy .
authors.forename: Stefano
authors.initials: S
authors.lastname: Angioni
authors.affiliation: b Division of Gynecology and Obstetrics, Department of Surgical Sciences , University of Pisa , Italy , and.
authors.forename: Vito
authors.initials: V
authors.lastname: Cela
authors.affiliation: a Division of Gynecology and Obstetrics, Department of Surgical Sciences , University of Cagliari , Cagliari , Italy .
authors.forename: Federica
authors.initials: F
authors.lastname: Sedda
authors.affiliation: a Division of Gynecology and Obstetrics, Department of Surgical Sciences , University of Cagliari , Cagliari , Italy .
authors.forename: Emanuela
authors.initials: E
authors.lastname: Stochino Loi
authors.affiliation: a Division of Gynecology and Obstetrics, Department of Surgical Sciences , University of Cagliari , Cagliari , Italy .
authors.forename: Vito
authors.initials: V
authors.lastname: Cofelice
authors.affiliation: c U.O.C Ospedale San Francesco , Nuoro , Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Pontis
authors.affiliation: a Division of Gynecology and Obstetrics, Department of Surgical Sciences , University of Cagliari , Cagliari , Italy .
authors.forename: Gian Benedetto
authors.initials: GB
authors.lastname: Melis
mesh_terms: D000328:Adult; D004715:Endometriosis / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000601:surgery*; D007410:Intestinal Diseases / Q000150:complications / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D027724:Reproductive Techniques, Assisted; D016896:Treatment Outcome; D001745:Urinary Bladder Diseases / Q000150:complications / Q000601:surgery*
keywords: Assisted reproductive technology; endometriosis; infertility; laparoscopy; surgery