title: The Surgical Treatment of Severe Endometriosis Positively Affects the Chance of Natural or Assisted Pregnancy Postoperatively.
abstract: OBJECTIVE
  To report reproductive outcomes following laparoscopic surgical excision of histologically confirmed r-ASRM stage III-IV endometriosis.
  
  
  METHODS
  A retrospective cohort study was performed at the Royal Hospital for Women, a university teaching hospital, Sydney, Australia. Women who had fertility-preserving laparoscopic excision of stage III-IV endometriosis from 1997 to 2009 were contacted regarding reproductive outcomes.
  
  
  RESULTS
  In the study period, 355 women underwent surgery for stage III-IV endometriosis. Follow-up data are available for 253/355 (71%) women. Postoperatively, 142/253 (56%) women attempted to conceive with a conception rate of 104/142 (73%). Confidence intervals for pregnancy for women who were attempting conception (including the nonresponders) range from 104/262 (40%) to 224/262 (85%). Median time to conception was 12 months. No positive prognostic factors for pregnancy were identified on regression analyses.
  
  
  CONCLUSIONS
  These data provide information to women with suspected severe disease preoperatively concerning their likely postoperative fertility outcomes. Ours is a population with severe endometriosis, rather than an infertile population with endometriosis, so caution needs to be applied when applying these data to women with fertility issues alone.
authors.affiliation: University of New South Wales, Sydney, Australia ; Royal Hospital for Women, Locked Bag 2000, Barker Street, Randwick, NSW 2031, Australia.
authors.forename: Erin M
authors.initials: EM
authors.lastname: Nesbitt-Hawes
authors.affiliation: University of New South Wales, Sydney, Australia ; Royal Hospital for Women, Locked Bag 2000, Barker Street, Randwick, NSW 2031, Australia.
authors.forename: Neil
authors.initials: N
authors.lastname: Campbell
authors.affiliation: University of New South Wales, Sydney, Australia.
authors.forename: Peta E
authors.initials: PE
authors.lastname: Maley
authors.affiliation: University of New South Wales, Sydney, Australia ; Royal Hospital for Women, Locked Bag 2000, Barker Street, Randwick, NSW 2031, Australia.
authors.forename: Haryun
authors.initials: H
authors.lastname: Won
authors.affiliation: Royal Hospital for Women, Locked Bag 2000, Barker Street, Randwick, NSW 2031, Australia.
authors.forename: Dona
authors.initials: D
authors.lastname: Hooshmand
authors.affiliation: University of New South Wales, Sydney, Australia ; Royal Hospital for Women, Locked Bag 2000, Barker Street, Randwick, NSW 2031, Australia.
authors.forename: Amanda
authors.initials: A
authors.lastname: Henry
authors.affiliation: University of New South Wales, Sydney, Australia ; Royal Hospital for Women, Locked Bag 2000, Barker Street, Randwick, NSW 2031, Australia.
authors.forename: William
authors.initials: W
authors.lastname: Ledger
authors.affiliation: University of New South Wales, Sydney, Australia ; Royal Hospital for Women, Locked Bag 2000, Barker Street, Randwick, NSW 2031, Australia.
authors.forename: Jason A
authors.initials: JA
authors.lastname: Abbott
mesh_terms: D001315:Australia / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D004715:Endometriosis / Q000601:surgery*; D005260:Female; D059247:Fertility Preservation / Q000706:statistics & numerical data; D013509:Gynecologic Surgical Procedures / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000706:statistics & numerical data*; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000601:surgery*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome