Role of Laparoscopy in Diagnosis and Treatment of Endometriosis Associated with Infertility: A Prospective Analysis (original) (raw)
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International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2020
Background: Endometriosis can be defined as presence of endometrial mucosa outside the uterine cavity. There are no specific signs and symptoms of endometriosis and the presentation may vary depending upon the site of involvement. It is one of the common causes of subfertility and infertility in young women. The Management of endometriosis may include medical as well as surgical intervention. Laparoscopic interventions have found to have encouraging results in terms of increasing chances of fertility in young women with endometriosis.Methods: This was a prospective study in which women who had infertility and subsequently diagnosed to be having endometriosis were included. A detailed history was taken with particular emphasis on duration of symptoms, presence of additional co-morbidities and duration of infertility was recorded. Diagnostic laparoscopy was done in all the cases. Depending upon location and severity of endometriosis adhesiolysis, excision and ablation of endometrial l...
Prevalence, Clinical and Laparoscopic Features of Endometriosis Among Infertile Women
The Journal of Obstetrics and Gynecology of India, 2016
Objective To study the prevalence, clinical and laparoscopic characteristics of endometriosis in infertile women. Study Design This is a hospital-based prospective study. Patients Five hundred and two (502) patients underwent diagnostic laparoscopy for evaluation of cause for infertility. Staging of endometriosis was done according to the rAFS scoring system. Results Out of 502 women, 276 (54.98 %) showed the presence of endometriosis, while 226 (45.01 %) did not have endometriosis. One hundred and eighty-three (66.3 %) women had stage I endometriosis, 49 (17.77 %) had stage II, 23 (8.33 %) had stage III and 21 (7.6 %) had stage IV endometriosis.
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Most endometriosis patients have fertility complaints and, in spite of the improvement of assisted reproduction procedures, outcomes remain unsatisfactory. This suggests that there are unknown ethiopathogenic influences that adversely affect fertility. Laparoscopic treatment of endometriosis is of questionable efficiency with regard to achieving better fertility results, with controversies mainly surrounding ovarian residual reserve. However, the laparoscopic approach follows good practice principles and is considered a minimally invasive procedure, with the advantage of being diagnostic and therapeutic. Decision to excise endometriomas must be taken cautiously, considering factors such as patient's age, previous ovarian reserve, previous pelvic surgery, presence of pain or malignancy suspicion, disease extension and the mean diameter of the lesions.
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The objectives of this study were to determine the importance of diagnostic laparoscopy for the accurate diagnosis of endometriosis and to correlate the findings with infertility. Participants in this study included 336 women who were 18–45 years old, had no past medical history of abdominal operations, and complained of chronic symptoms of pelvic pain. In all these cases there were no
Fertility and sterility, 2016
To evaluate fertility outcomes in infertile women with severe endometriosis (The revised American Fertility Society classification [AFS] 3-4) and repeated IVF failures, who underwent surgery due to exacerbation of endometriosis-related symptoms. Retrospective cohort study. University hospital. All women who failed IVF treatment before surgery and who underwent laparoscopic surgery for severe endometriosis between January 2006 and December 2014. All patients were operated by highly skilled surgeons specializing in laparoscopic surgery for advanced endometriosis. Only patients with evidence of endometriosis in the pathology specimens were included in this study. Delivery rate after surgery. Seventy-eight women were included in the present study. All women were diagnosed with severe endometriosis during surgery (AFS 3-4) and all women had experienced failed IVF treatments before surgery. All women were symptomatic before their surgery. After surgical treatment 33 women (42.3%) delivere...
American journal of translational research, 2021
INTRODUCTION Endometriosis is an illness caused by the presence of foci of endometrial implants outside the uterine cavity. Laparoscopy (minimally invasive surgical method) is considered as the definitive treatment for Endometriosis. METHOD Clinical data from January 2014 till December 2018, between the ages of 20 and 40 years were collected. A total of 175 women with pelvic Endometriosis complicated with infertility, underwent laparoscopy in our hospital, were followed up to assess fertility outcome. We analyzed using univariate logistic regression analysis as well as multivariate logistic analysis. RESULTS We analyzed the relationship between them by logistic regression analysis. Univariate logistic regression analysis indicated that the significant factors for influencing pregnancy were the following factors: age, infertility types: primary or secondary infertility, treatment with Gonadotrophin Releasing Hormone-agonist, r-AFS grade, operative method: excision or ablation. And mu...
International Journal of Gynecology & Obstetrics, 1998
Objecti®e: To assess the discrepancy between laparoscopic and laparotomic scoring methods using the revised Ž . American Fertility Society AFS classification of endometriosis. Method: In this prospective study, 84 patients with Ž . endometriosis were scored twice laparoscopically and laparotomically by the same subspecialty-certified reproductive endocrinologist. The magnitude of inter-method variability was reported quantitatively by the S.D. of the differences in scores between the pairs. The differences in the mean endometriosis scores between the two methods were assessed by the paired Student's t-test. P-0.05 was considered as statistically significant. Discrepancy between the two methods in the staging of endometriosis patients was presented by kappa measure of agreement. Result: There was considerable variability in the scores between the two scoring methods by the same observer. Among individual components of the scoring system, the greatest variability occurred in the ovarian endometriosis and cul-de-sac obliteration subscores, with the least variability observed for peritoneum endometriosis. The inter-method variation in score was sufficient to alter the endometriosis staging in 34.5% of patients, including a difference of two stages in 3.6% of patients. The kappa coefficient was 0.49, indicating fair-to-good agreement between the two scoring methods. Conclusion: Inter-method variability between laparoscopic and laparotomic scoring methods was high for ovarian endometriosis subscore using the revised AFS classification of endometriosis. Agreement in endometriosis staging between the two methods was fair to good. ᮊ 1998 International Federation of Gynecology and Obstetrics
Reproductive outcome after surgical treatment of endometriosis--retrospective analytical study
Ginekologia polska, 2013
The aim of the study was to investigate the reproductive outcomes of patients after surgical treatment of endometriosis. The study included 100 infertile women, aged 21 to 41 years, who underwent surgical treatment of endometriosis. From January 2007 to January 2012, excision of endometriosis was performed by operative laparoscopy or laparotomy Demographic, clinical, surgical and reproductive outcomes of 52 patients were retrospectively analyzed. Twenty-three pregnancies (44%) were obtained in 52 patients, resulting in 16 term pregnancies, 4 spontaneous abortions under 16 weeks gestation, 2 spontaneous abortions at 20 gestational weeks and 1 ectopic pregnancy Twenty nine patients did not achieve pregnancy and 68.9% (20/29) of them were treated with IVF-ICSI. Spontaneous pregnancies were obtained within 7 months after the surgery whereas IVF-ICSI pregnancies were obtained within the period of 11 months. Seven patients were stage 1, 14 patients stage II, 19 patients stage III, and 12 ...
Diagnostic and therapeutic laparoscopy in the management of endometriosis
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2018
Background: Endometriosis associated with a variety of symptoms, primarily produces dysmenorrhea and infertility. Three classes of techniques have been used to diagnose women with endometriosis beside the history and the clinical picture: biochemical markers, radiological imaging and laparoscopic examination of peritoneal cavity.Methods: All 52 patients were evaluated clinically, biochemically, and radiologically and laparascopically to find out the abnormalities.Results: Most common complaint in a patient with endometriosis is dysmenorrhea affecting 67.6% population in this study group. 20% patients presented with infertility. Diagnostic laparoscopy of the patients in the study group show ovarian endometrioma in 67.3% population. Stage II endometriosis was seen in maximum number of cases in the study group comprising 46.2% patients. Ovarian cystectomy was the most common therapeutic procedure done in 51.9% of patients, out of which 40.4% cases treated with unilateral cystectomy and...