HEALTH AND FERTILITY OUTCOMES AMONG WOMEN SURGICALLY TREATED FOR ENDOMETRIOSIS

Study Objective, To assess health and fertility status among women aft er surgical treatment of endometriosis. Design. Prospective study. Set ting. Community-based gynecologic specialty practice. Patients. Two hu ndred ninety women with newly diagnosed endometriosis. Measurements an d Main Results, Medical records of all women were abstracted at baseli ne; self-administered questionnaires were used to collect follow-up da ta. Most women (68-79%) reported some or great improvement in symptomo logy after surgical treatment. One hundred twenty-four (53%) of 232 wo men reported one or more pregnancies, two-thirds of which resulted in live births. Secondary sex ratios were below 1 (range 0.92-0.50), refl ecting a female excess. Logistic regression analysis identified previo us live birth as the only significant predictor of pregnancy after sur gery; advancing maternal age significantly decreased the likelihood of a live birth. Conclusions, Overall, these women reported improvement in symptoms al follow-up. Operative and clinical findings were not sig nificant predictors of pregnancy likelihood. Prior live birth conferre d more than a twofold increase in pregnancy likelihood, whereas advanc ing age decreased the likelihood. Reasons for reversed sex ra ties are unknown but warrant further study.