title: Spontaneous fertility after expectant or surgical management of rectovaginal endometriosis in women with or without ovarian endometrioma: a retrospective analysis.
abstract: OBJECTIVE
  To investigate spontaneous pregnancy rate (SPRs) of women with rectovaginal endometriosis (RV) with/without ovarian endometrioma (OMA) and treated with the use of expectant or surgical management.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  The study included patients with RV with or without OMA who tried to conceive spontaneously for 1 year either without undergoing surgery (group E; n = 284) or after surgery (group S; n = 221). The study population was further divided into four subgroups: women with RV without OMA who directly tried to conceive (group eRV; n = 121) or tried to conceive after surgery (group sRV; n = 96), and women with RV with OMA who directly tried to conceive (group eOMA; n = 163) or tried to conceive after surgery (group sOMA; n = 125).
  
  
  METHODS
  Expectant or surgical management.
  
  
  METHODS
  Crude and cumulative SPRs.
  
  
  RESULTS
  At 1 year, crude and cumulative SPRs were lower in group E (17.3% and 23.8%, respectively) than in group S (35.7% and 39.5%). Similarly, crude and cumulative SPRs were lower in group eRV (24.8% and 30.6%) than in group sRV (42.7% and 45.7%, respectively) and in group eOMA (11.7% and 18.0%) than group sOMA (30.4% and 34.5%). At 1 year, crude and cumulative SPRs were higher in group eRV (24.8% and 30.6%) than in group eOMA (11.7% and 18.0%), and in group sRV (42.7% and 45.7%) than in group sOMA (30.4% and 34.5%).
  
  
  CONCLUSIONS
  Crude and cumulative SPRs are lower in women treated with the use of expectant rather than surgical management. The presence of OMAs decreases SPRs independently from the treatment modality adopted.
authors.affiliation: Academic Unit of Obstetrics and Gynecology, IRCCS AOU San Martino-IST, Genoa, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, University of Genoa, Genoa, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Leone Roberti Maggiore
authors.affiliation: Academic Unit of Obstetrics and Gynecology, IRCCS AOU San Martino-IST, Genoa, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, University of Genoa, Genoa, Italy.
authors.forename: Carolina
authors.initials: C
authors.lastname: Scala
authors.affiliation: Academic Unit of Obstetrics and Gynecology, IRCCS AOU San Martino-IST, Genoa, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, University of Genoa, Genoa, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Tafi
authors.affiliation: Academic Unit of Obstetrics and Gynecology, IRCCS AOU San Martino-IST, Genoa, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, University of Genoa, Genoa, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Racca
authors.affiliation: Department of Radiology, Galliera Hospital, Genoa, Italy.
authors.forename: Ennio
authors.initials: E
authors.lastname: Biscaldi
authors.affiliation: Department of Surgical and Diagnostic Sciences, IRCCS San Martino Hospital and National Institute for Cancer Research, University of Genoa, Genoa, Italy.
authors.forename: Valerio Gaetano
authors.initials: VG
authors.lastname: Vellone
authors.affiliation: Academic Unit of Obstetrics and Gynecology, IRCCS AOU San Martino-IST, Genoa, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, University of Genoa, Genoa, Italy.
authors.forename: Pier Luigi
authors.initials: PL
authors.lastname: Venturini
authors.affiliation: Academic Unit of Obstetrics and Gynecology, IRCCS AOU San Martino-IST, Genoa, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, University of Genoa, Genoa, Italy. Electronic address: simone.ferrero@unige.it.
authors.forename: Simone
authors.initials: S
authors.lastname: Ferrero
mesh_terms: D000328:Adult; D004715:Endometriosis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005298:Fertility; D006785:Hospitals, University; D006801:Humans; D007247:Infertility, Female / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D050498:Live Birth; D008423:Maternal Age; D010049:Ovarian Diseases / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D011247:Pregnancy; D018873:Pregnancy Rate; D012002:Rectal Diseases / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D061685:Time-to-Pregnancy; D016896:Treatment Outcome; D014623:Vaginal Diseases / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*
keywords: Endometrioma; endometriosis; fertility; pregnancy rate; surgery