Long-term fertility after laparoscopy for endometriosis-associated pelvic pain in young adult women

J Minim Invasive Gynecol. Nov-Dec 2014;21(6):1061-6. doi: 10.1016/j.jmig.2014.05.002. Epub 2014 May 22.

Abstract

Study objective: To describe the long-term fertility outcomes in young patients with endometriosis-associated pelvic pain treated with laparoscopic surgery.

Design: Retrospective case series (Canadian Task Force classification II-2).

Setting: Tertiary care hospital.

Patients: Women aged 18 to 25 years who underwent laparoscopic surgery between 2000 and 2005 at the Cleveland Clinic Foundation solely to treat endometriosis-associated pelvic pain.

Interventions: Patients answered a telephone or mail survey questionnaire assessing fertility outcome after surgery.

Measurements and main results: Twenty-eight of 74 eligible patients (37.8%) were enrolled in the study. With a median (interquartile range) age of 23.5 (1.5) years at follow-up, these patients completed the telephone or postal questionnaire to assess fertility outcomes at follow-up of 102.5 (16.6) months. In most participants the diagnosis was less advanced endometriosis (stage I, 60.7%; stage II, 28.6%). Twenty women (71.4%) had at least 1 pregnancy during follow-up that resulted in a live birth, of which >80% were spontaneous without the use of assisted reproductive technologies.

Conclusion: Long-term pregnancy rates are excellent in young women undergoing laparoscopic surgery to treat pelvic pain. However, a future prospective study is needed to determine whether laparoscopy has any hindrance on future fertility.

Keywords: Endometriosis; Fertility; Laparoscopy; Pelvic pain.

MeSH terms

  • Adnexal Diseases / complications
  • Adnexal Diseases / epidemiology
  • Adnexal Diseases / surgery*
  • Adolescent
  • Adult
  • Endometriosis / complications
  • Endometriosis / epidemiology
  • Endometriosis / surgery*
  • Female
  • Fertility*
  • Humans
  • Laparoscopy* / adverse effects
  • Pelvic Pain / etiology
  • Pelvic Pain / surgery*
  • Pregnancy
  • Pregnancy Rate
  • Retrospective Studies
  • Surveys and Questionnaires
  • Treatment Outcome
  • Young Adult