S. Milingos et al., Factors affecting postoperative pregnancy rate after endoscopic managementof large endometriomata, INT J GYN O, 63(2), 1998, pp. 129-137
Objective: To identify factors influencing postoperative pregnancy rate in
women with extensive endometriosis and large endometriomata as the only ide
ntified cause of infertility that were treated by laparoscopy. Method: Sixt
y-four infertile patients with endometriomata (greater than or equal to 3 c
m) and no other apparent cause of infertility. The latter were removed by o
perative laparoscopy. Life table calculations, the Student's t-test and the
chi(2) test were used where appropriate. Result: Thirty-four patients (53%
) became pregnant during the 2-year follow-up period. A significantly incre
ased pregnancy rate was found for the first year compared to the second (76
vs. 24%). The existence of adhesions affected adversely the outcome of the
operation only as far as early achievement of pregnancy is considered. The
number and size of endometriomata and the existence of peritoneal implants
have not been found to affect pregnancy rates. The severity of the disease
did not affect pregnancy rate, but in the cases with moderate disease most
of the pregnancies were achieved during the first postoperative year. The
duration of infertility was significantly associated only at the 10% level
with decreased pregnancy rates. Conclusion: Extensive endometriosis with la
rge endometriomata can be safely and effectively treated with laparoscopy u
sing the traditional laparoscopic tools providing the infertile patient wit
h a high chance to conceive in a relatively short period of time postoperat
ively. (C) 1998 International Federation of Gynecology and Obstetrics.