Determinant factors of fertility outcomes after laparoscopic colorectal resection for endometriosis

被引：44

作者：

Darai, Emile ^{[1
]}

Carbonnel, Marie ^{[1
]}

Dubernard, Gil ^{[1
]}

Lavoue, Vincent ^{[1
]}

Coutant, Charles ^{[1
]}

Bazot, Marc ^{[2
]}

Ballester, Marcos ^{[1
]}

机构：

[1] Univ Paris 06, Hop Tenon, AP HP, Serv Gynecol Obstet, F-75020 Paris, France

[2] Univ Paris 06, Hop Tenon, AP HP, Serv Radiol, F-75020 Paris, France

来源：

EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY | 2010年 / 149卷 / 02期

关键词：

Endometriosis; Colorectal endometriosis; Laparoscopy; Fertility; Pregnancy; RECTAL ENDOSCOPIC SONOGRAPHY; QUALITY-OF-LIFE; TERM-FOLLOW-UP; PELVIC ENDOMETRIOSIS; ADENOMYOSIS; PREDICTION; PREVALENCE; MANAGEMENT; PREGNANCY; DIAGNOSIS;

D O I：

10.1016/j.ejogrb.2009.12.032

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

Objective: The aims of this prospective study were to evaluate fertility, pregnancy outcomes and their determinant factors after laparoscopic segmental colorectal resection for endometriosis. Study design: We studied 83 women who underwent colorectal resection for endometriosis. Thirty-nine women (47%) had an associated infertility and 51(61.4%) wished to conceive after surgery. Surgical route was exclusive laparoscopy in 77 cases (92.7%) and laparoconversion in 6 (7.3%). Results: Twenty-nine pregnancies were obtained in 24 patients (43.6%) including 20 spontaneous (69%) and 9 by IVF (31%). The median time to conceive spontaneously was 6 months and 20 months by IVF. Among the 39 infertile women, 18 (46%) conceived during the study period. A relation was found between pregnancy rate and patient age (p = 0.02). Reduction in pregnancy rate was correlated to the presence of adenomyosis (p = 0.04) and high ASRM total score (p < 0.001) as well as exclusive laparoscopy compared to conversion to laparotomy for colorectal resection (p = 0.01). Conclusion: Adenomyosis and conversion to laparotomy as well as patient age. ASRM score appeared determinant factors of fertility outcome. (C) 2010 Elsevier Ireland Ltd. All rights reserved.

引用

页码：210 / 214

页数：5

共 31 条

[1] Laparoscopic excision of endometriosis: a randomized, placebo-controlled trial [J].

Abbott, J ;

Hawe, J ;

Hunter, D ;

Holmes, M ;

Finn, P ;

Garry, R .

FERTILITY AND STERILITY, 2004, 82 (04) :878-884

[2]

BAILEY HR, 1994, DIS COLON RECTUM, V37, P747

[3] Adenomyosis in endometriosis - prevalence and impact on fertility. Evidence from magnetic resonance imaging [J].

Bazot, M ;

Fiori, O ;

Darai, E .

HUMAN REPRODUCTION, 2006, 21 (04) :1101-1102

[4] Deep pelvic endometriosis: MR imaging for diagnosis and prediction of extension of disease [J].

Bazot, M ;

Darai, E ;

Hourani, R ;

Thomassin, I ;

Cortez, A ;

Uzan, S ;

Buy, JN .

RADIOLOGY, 2004, 232 (02) :379-389

[5] Transvaginal sonography and rectal endoscopic sonography for the assessment of pelvic endometriosis:: a preliminary comparison [J].

Bazot, M ;

Detchev, R ;

Cortez, A ;

Amouyal, P ;

Uzan, S ;

Daraï, E .

HUMAN REPRODUCTION, 2003, 18 (08) :1686-1692

[6] Fast breath-hold T2-weighted MR imaging reduces interobserver variability in the diagnosis of adenomyosis [J].

Bazot, M ;

Daraï, E ;

de Givry, SC ;

Boudghène, F ;

Uzan, S ;

Le Blanche, AF .

AMERICAN JOURNAL OF ROENTGENOLOGY, 2003, 180 (05) :1291-1296

[7] Accuracy of magnetic resonance imaging and rectal endoscopic sonography for the prediction of location of deep pelvic endometriosis [J].

Bazot, Marc ;

Bornier, Carole ;

Dubernard, Gil ;

Roseau, Gilles ;

Cortez, Annie ;

Darai, Emile .

HUMAN REPRODUCTION, 2007, 22 (05) :1457-1463

[8] Laparoscopically assisted vaginal management of deep endometriosis infiltrating the rectovaginal septum [J].

Chapron, C ;

Jacob, S ;

Dubuisson, JB ;

Vieira, M ;

Liaras, E ;

Fauconnier, A .

ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA, 2001, 80 (04) :349-354

[9] Ovarian reserve [J].

Coccia, Maria Elisabetta ;

Rizzello, Francesca .

ASSESSMENT OF HUMAN REPRODUCTIVE FUNCTION, 2008, 1127 :27-30

[10]

CORONADO C, 1990, FERTIL STERIL, V53, P411

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