Postoperative Reproductive Outcomes in Patients with Endometriosis-Associated Infertility: A Single-Center Retrospective Study.

IF 2 4区 医学 Q2 OBSTETRICS & GYNECOLOGY
Gynecologic and Obstetric Investigation Pub Date : 2024-01-01 Epub Date: 2024-05-03 DOI:10.1159/000539142
Khayal Gasimli, Dilara Akpinar, Bahar Gasimli, Annette Bachmann, Norbert Maczó, Rudy Leon De Wilde, Antoine Naem, Harald Krentel, Sven Becker, Morva Tahmasbi Rad
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引用次数: 0

Abstract

Objectives: Endometriosis is a chronic inflammatory disease known to contribute to infertility. Laparoscopic excision of endometriotic lesions represents a standard treatment modality for symptomatic women. Our study aims to assess the potential benefits of laparoscopic excision of endometriosis in patients experiencing infertility associated with the condition, as well as to define the clinical factors that may impact the cumulative pregnancy rate.

Design: In this retrospective analysis, a total of 102 patients with endometriosis-related infertility were enrolled.

Materials, setting, methods: All participants underwent reproductive surgery and were then categorized into two groups: those who conceived were assigned to group A, while those who did not were assigned to group B. The correlation between clinical factors and pregnancy rate was assessed using the log-rank test, and both univariate and multivariate analyses were conducted utilizing the Cox regression model.

Results: The median age of the patients was 33.5 years, with a median follow-up duration of 70 months. Throughout the study period, 71 patients (69.6%) conceived (group A), while the remaining 31 patients (30.4%) did not conceive (group B), irrespective of the use of Assisted-Reproduction Technologies. The Cox regression model revealed that factors such as the duration of infertility, presence of deep infiltrating endometriosis, bowel endometriosis, rASRM stages, pelvic adhesions, and recurrent disease negatively impacted postoperative conception rates. Conversely, complete excision and coagulation of endometriotic lesions, as well as ablation of ovarian endometriomas, emerged as independent positive predictive factors for postoperative clinical pregnancy.

Limitations: Limitations of this study is retrospective design of the study, as well as a small number of patients.

Conclusions: Complete excision of endometriosis during reproductive surgery may yield a positive effect and optimize the likelihood of pregnancy in patients with endometriosis-related infertility.

子宫内膜异位症相关不孕症患者的术后生殖效果:单中心回顾性研究。
目的:子宫内膜异位症是一种慢性炎症性疾病,已知会导致不孕。腹腔镜子宫内膜异位症病灶切除术是针对有症状妇女的一种标准治疗方式。我们的研究旨在评估腹腔镜子宫内膜异位症切除术对不孕症患者的潜在益处,并确定可能影响累积妊娠率的临床因素:在这项回顾性分析中,共纳入了102名子宫内膜异位症相关不孕症患者:采用对数秩检验评估临床因素与妊娠率之间的相关性,并利用 Cox 回归模型进行单变量和多变量分析。结果 患者的中位年龄为 33.5 岁,中位随访时间为 70 个月。在整个研究期间,71 名患者(69.6%)受孕(A 组),其余 31 名患者(30.4%)未受孕(B 组),无论是否使用辅助生殖技术。Cox 回归模型显示,不孕时间长短、是否存在深部浸润性子宫内膜异位症、肠道子宫内膜异位症、rASRM 分期、盆腔粘连和复发疾病等因素对术后受孕率有负面影响。相反,子宫内膜异位症病灶的完全切除和凝固,以及卵巢子宫内膜瘤的消融,则是术后临床妊娠的独立积极预测因素:局限性:本研究为回顾性研究,患者人数较少:结论:在生殖手术中完全切除子宫内膜异位症可能会产生积极的效果,并提高子宫内膜异位症相关不孕症患者怀孕的可能性。
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来源期刊
CiteScore
4.20
自引率
4.80%
发文量
44
审稿时长
6-12 weeks
期刊介绍: This journal covers the most active and promising areas of current research in gynecology and obstetrics. Invited, well-referenced reviews by noted experts keep readers in touch with the general framework and direction of international study. Original papers report selected experimental and clinical investigations in all fields related to gynecology, obstetrics and reproduction. Short communications are published to allow immediate discussion of new data. The international and interdisciplinary character of this periodical provides an avenue to less accessible sources and to worldwide research for investigators and practitioners.
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