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Fertility after surgery for deep infiltrating endometriosis
1Service de gynécologie obstétrique, hôpital Félix-Guyon, CHU de la Réunion, allée des Topazes, CS 11021, 97405 Saint-Denis cedex, Reunion.
Journal of Gynecology Obstetrics and Human Reproduction
|April 14, 2017
Summary
Fertility outcomes after deep infiltrating endometriosis surgery are generally good, though complications can delay pregnancy. High rates of premature delivery were observed, and successful pregnancy did not occur in cases of incomplete resection or after age 36.
Area of Science:
- Reproductive Medicine
- Surgical Gynecology
- Endometriosis Research
Background:
- Reunion Island exhibits a high prevalence of endometriosis, significantly impacting female fertility.
- Deep infiltrating endometriosis (DIE) poses a substantial challenge to reproductive health in affected populations.
Purpose of the Study:
- To evaluate the fertility and pregnancy outcomes of women who underwent surgical treatment for deep infiltrating endometriosis.
- To identify factors influencing pregnancy success and characteristics of pregnancies post-DIE surgery.
Main Methods:
- A retrospective study was conducted across two centers at the CHU of Reunion Island.
- Included were women desiring pregnancy who were operated on for deep endometriosis between January 2012 and May 2013.
Main Results:
- Out of 63 women, 42.9% achieved pregnancy, with 44.4% conceiving spontaneously. The average time to first pregnancy was 14.2 months.
- Complete resection of endometriosis was achieved in 92% of cases. Among 34 pregnancies, 20 resulted in live births, with a 35% premature delivery rate.
- Pregnancy complications included a 25.4% complication rate from surgery and a 10% cesarean section rate.
Conclusions:
- Surgical intervention for deep infiltrating endometriosis can lead to good fertility outcomes, but complications may increase the time to conception.
- A high rate of premature delivery (35%) was noted. Successful pregnancies were not observed in women with incomplete resection or over the age of 36.