Pregnancy rates after laparoscopic treatment - Differences related to tubal status and presence of endometriosis

OBJECTIVE: To examine how preexisting tubal adhesions and endometriosis aff ect pregnancy outcome after laparoscopic treatment in infertile women with no apparent causes of infertility other than tubal factors. STUDY DESIGN: Pregnancy outcomes in 186 infertile women for a follow-up per iod of 18 months after laparoscopy were analyzed. Laparoscopic manipulation s consisted of adhesiolysis of tubes and removal of endometriotic lesions. RESULTS: The patients were classified into three groups, those with no tuba l adhesions (group A, n = 83), unilateral tubal adhesions (group B, n = 46) and bilateral tubal adhesions with at least one tube patent (group C, n = 57). The cumulative pregnancy rate in group C (13.2%) was lower than in gro ups A (41.8%) and B (45.7%) 18 months after laparoscopy. The average time t o conception in group A (6.7 +/- 0.8 months) tended to be shorter than that in group B (10.6 +/- 1.2 months). In group A, pregnancy rates were essenti ally the same between minimal/mild endometriosis and moderate/severe endome triosis. Regarding group B, women with minimal/mild endometriosis exhibited significantly higher pregnancy rates than those with moderate/severe endom etriosis, while pregnancy rates in women without endometriosis fell in betw een. CONCLUSION: Pregnancy rates after laparoscopic treatment are different in r elation to tubal status and the presence of endometriosis.