Second live birth after undergoing assisted reproductive technology in women operated on for endometriosis.
OBJECTIVE
To determine prognostic factors for a second live birth, after a first child obtained through assisted reproductive techniques (ART).


METHODS
Observational study from January 2004 to December 2014.


METHODS
Tertiary care university hospital and ART center.


METHODS
A total of 164 infertile patients with endometriosis, who underwent laparoscopy surgery and had a first baby obtained by ART, were included and 65 wished a second baby.


METHODS
No iterative surgery.


METHODS
Spontaneous pregnancy rate (PR) according to endometriosis fertility index.


RESULTS
Among the cohort, 27 patients (41.5%) gave birth to a second child through spontaneous pregnancy, whereas 23 patients (35.3%) required ART to obtain a second live birth. No difference was observed between patients regarding age, endometriosis staging, complete removal of endometriosis lesions and pelvic adhesion, except for the least function score, and the endometriosis fertility index. Taking into account irrespective of both mode of conception a total of 78% of patients obtained a second child, with a median conception time of 17 months.


CONCLUSIONS
The second live birth rate in infertile patients with endometriosis and with surgical treatment was high (78%). Spontaneous PR was 54%. Endometriosis fertility index could be considered as a predictive factor for a spontaneous second pregnancy in fertility management. Our results need to be confirmed in larger prospective studies.
Department of Obstetrics, Gynecology and Reproductive Medecine, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Bondy, France; Université Paris 13, Sorbonne Paris Cité, UFR SMBH, Bobigny, France. Electronic address: jeremy.boujenah@gmail.com.
Jérémy
J
Boujenah
Department of Obstetrics, Gynecology and Reproductive Medecine, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Bondy, France; Université Paris 13, Sorbonne Paris Cité, UFR SMBH, Bobigny, France.
Jean-Noel
JN
Hugues
Université Paris 13, Sorbonne Paris Cité, UFR SMBH, Bobigny, France; Reproductive Biology, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Bondy, France.
Christophe
C
Sifer
Department of Obstetrics, Gynecology and Reproductive Medecine, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Bondy, France; Université Paris 13, Sorbonne Paris Cité, UFR SMBH, Bobigny, France.
Isabelle
I
Cedrin-Durnerin
Department of Obstetrics, Gynecology and Reproductive Medecine, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Bondy, France; Université Paris 13, Sorbonne Paris Cité, UFR SMBH, Bobigny, France.
Alexandre
A
Bricou
Department of Obstetrics, Gynecology and Reproductive Medecine, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Bondy, France; Université Paris 13, Sorbonne Paris Cité, UFR SMBH, Bobigny, France.
Christophe
C
Poncelet
D000328:Adult; D004715:Endometriosis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005298:Fertility; D005602:France; D006801:Humans; D007247:Infertility, Female / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D010535:Laparoscopy; D050498:Live Birth; D010298:Parity; D011247:Pregnancy; D027724:Reproductive Techniques, Assisted; D062606:Tertiary Care Centers; D013997:Time Factors; D061685:Time-to-Pregnancy; D016896:Treatment Outcome
ART; Endometriosis; fertility index; laparoscopy; live birth