Laparoscopy for Endometriosis Complicated with Infertility:Report of 104 Cases / 中国微创外科杂志

ABSTRACT

Objective To investigate the outcomes of laparoscopic surgery for endometriosis complicated with infertility and the related factors influencing the post-treatment pregnancy.Methods Between January 2006 and January 2007,104 patients with endometriosis complicated with infertility,including 19 r-AFS stage Ⅰ cases,15 stage Ⅱ cases,36 stage Ⅲ cases,and 34 stage Ⅳ cases,were treated in our hospital.The ectopic endometrial tissues were removed by laparoscopy in all of the patients.And adherent tissues were freed at the mean time.After the procedures,Methylene blue was used to test the patency of the Fallopian tubes.For cases with obstructed Fallopian tubes,salpingoplasty was performed as well.After the operation,the patients received gestrinone therapy for 3 to 6 months and were followed up for pregnancy rate.Results The laparoscopic procedures were completed in all of the 104 cases.The post-operational rate of pregnancy was 38.5%(40/104).In women with stage Ⅰ endometriosis,the pregnancy rate was 42.1%(8/19),while in the stages Ⅱ,Ⅲ,and Ⅳ,the rate was 40.0%(6/15),36.1%(13/36),and 38.2%(13/34),respectively(?2=0.206,P=0.977).The pregnancy rate of the patients with single ovarian chocolate cyst was 54.8%(23/42),and that in the patients with chocolate cyst complicated with ectopic endometrium in other positions or those without chocolate cyst were 22.9%(8/35) and 33.3%(9/27) respectively(?2=8.616,P=0.013).The postoperative pregnancy rate of the patients with chocolate cyst in the right ovary [81.3%(13/16)] was significantly higher than that in the cases with left chocolate cyst [35.7%(5/14)] or chocolate cyst in both sides [41.7%(5/12)](?2=7.412,P=0.025).Conclusions Laparoscopy is effective for endometriosis complicated with infertility with high post-operative pregnancy rate.EMT stages show no effect on the pregnancy rate,which may be associated with the position of ectopic endometrium and the side of chocolate cysts.