Laparoscopic evaluation and prevalence of endometriosis among infertile women: a prospective study

ABSTRACT

Background: Endometriosis can be defined as presence of endometrial mucosa outside the uterine cavity. There are no specific signs and symptoms of endometriosis and the presentation may vary depending upon the site of involvement. It is one of the common causes of subfertility and infertility in young women. The Management of endometriosis may include medical as well as surgical intervention. Laparoscopic interventions have found to have encouraging results in terms of increasing chances of fertility in young women with endometriosis.Methods: This was a prospective study in which women who had infertility and subsequently diagnosed to be having endometriosis were included. A detailed history was taken with particular emphasis on duration of symptoms, presence of additional co-morbidities and duration of infertility was recorded. Diagnostic laparoscopy was done in all the cases. Depending upon location and severity of endometriosis adhesiolysis, excision and ablation of endometrial lesions was done. Patients were followed up and successful pregnancies (spontaneous as well as secondary to assisted reproductive techniques) were recorded.Results: Out of 200 studied cases endometriosis was seen in 23 (11.5%) patients. the most common affected age group was between 26-30 years (47.83%). 18 patients (78.26%) had primary infertility whereas remaining 5 patients (21.74%) were found to have secondary infertility. The most common site was found to be ovaries which was found to be involved in all the cases. cystectomy (30.43%), endometrioma drainage and fulguration (13.04%) or adhesiolysis (34.78%) were the commonly done surgical interventions in cases. out of 18 patients who had successful ovulation following laparoscopic intervention 12 (66.66%) patients completed their pregnancies successfully.Conclusions: Laparoscopic interventions in patients with infertility have diagnostic as well as therapeutic value and are found to have good outcome in terms of successful pregnancy.