TY - JOUR
T1 - Reproductive performance in infertile women with rectovaginal endometriosis
T2 - Is surgery worthwhile?
AU - Vercellini, Paolo
AU - Pietropaolo, Giuliana
AU - De Giorgi, Olga
AU - Daguati, Raffaella
AU - Pasin, Roberta
AU - Crosignani, Pier Giorgio
PY - 2006/11
Y1 - 2006/11
N2 - Objective: This study was undertaken to ascertain whether the incidence of pregnancy is increased and time-to-conception is reduced in infertile women with rectovaginal endometriosis undergoing conservative surgery compared with those on expectant management. Study design: A total of 105 infertile women under the age of 40 years with rectovaginal endometriosis and no other associated major infertility factor underwent first-line conservative surgery at laparotomy or expectant management according to a shared decision-making approach. Results: Among the 44 women who had resection of rectovaginal endometriosis, 15 became pregnant, compared with 22 of the 61 women who choose expectant management (24-month cumulative probabilities, 44.9% and 46.8%, respectively; log-rank test, χ21 = 0.75; P = .38). One major and 9 minor postoperative complications occurred. Significant differences in pain-free survival time in favor of the surgery group were observed for dysmenorrhea, dyspareunia, and dyschezia. Conclusion: Conservative surgery for rectovaginal endometriosis in infertile women does not modify the reproductive prognosis although it does increase pain-free survival time.
AB - Objective: This study was undertaken to ascertain whether the incidence of pregnancy is increased and time-to-conception is reduced in infertile women with rectovaginal endometriosis undergoing conservative surgery compared with those on expectant management. Study design: A total of 105 infertile women under the age of 40 years with rectovaginal endometriosis and no other associated major infertility factor underwent first-line conservative surgery at laparotomy or expectant management according to a shared decision-making approach. Results: Among the 44 women who had resection of rectovaginal endometriosis, 15 became pregnant, compared with 22 of the 61 women who choose expectant management (24-month cumulative probabilities, 44.9% and 46.8%, respectively; log-rank test, χ21 = 0.75; P = .38). One major and 9 minor postoperative complications occurred. Significant differences in pain-free survival time in favor of the surgery group were observed for dysmenorrhea, dyspareunia, and dyschezia. Conclusion: Conservative surgery for rectovaginal endometriosis in infertile women does not modify the reproductive prognosis although it does increase pain-free survival time.
KW - Conservative surgery
KW - Endometriosis
KW - Infertility
KW - Pelvic pain
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U2 - 10.1016/j.ajog.2006.03.068
DO - 10.1016/j.ajog.2006.03.068
M3 - Article
C2 - 16707075
AN - SCOPUS:33750312725
VL - 195
SP - 1303
EP - 1310
JO - American Journal of Obstetrics and Gynecology
JF - American Journal of Obstetrics and Gynecology
SN - 0002-9378
IS - 5
ER -