Fertility after bowel resection for endometriosis

Objective To determine the pregnancy rate after bowel resection for rectosigmoid endometriosis. Design Prospective cohort study. Setting University hospital. Patient(s) Forty-six symptomatic women with bowel endometriosis requiring colorectal resection. Intervention(s) Bowel resection by either lapa...

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Bibliographic Details
Published in:Fertility and sterility 2009-07, Vol.92 (1), p.41-46
Main Authors: Ferrero, Simone, M.D, Anserini, Paola, M.D, Abbamonte, Luiza Helena, M.D, Ragni, Nicola, M.D, Camerini, Giovanni, M.D, Remorgida, Valentino, M.D
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Birth control
Bowel endometriosis
bowel resection
Digestive system. Abdomen
endometriosis
Endometriosis - physiopathology
Endometriosis - surgery
Endoscopy
Female
Female genital diseases
Fertility - physiology
Gynecology. Andrology. Obstetrics
Humans
infertility
Internal Medicine
Investigative techniques, diagnostic techniques (general aspects)
Laparoscopy
Laparotomy
Medical sciences
Non tumoral diseases
Obstetrics and Gynecology
Postoperative Complications - epidemiology
Pregnancy
pregnancy outcome
Pregnancy Rate
Rectal Diseases - etiology
Rectal Diseases - surgery
Sigmoid Diseases - etiology
Sigmoid Diseases - surgery
Sterility. Assisted procreation
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Summary:Objective To determine the pregnancy rate after bowel resection for rectosigmoid endometriosis. Design Prospective cohort study. Setting University hospital. Patient(s) Forty-six symptomatic women with bowel endometriosis requiring colorectal resection. Intervention(s) Bowel resection by either laparoscopy or laparotomy. Main Outcome Measure(s) Pregnancy rate after surgery. Result(s) The pregnancy rate was higher in women who underwent bowel resection by laparoscopy (57.6%) than in those who underwent laparotomy (23.1%). No significant difference was observed in pregnancy rate and mode of conception between women with different fertility status before bowel resection. Women who conceived were significantly younger than those who did not conceive; only 26.7% of women aged ≥35 years conceived after bowel resection. Uterine adenomyosis was more frequently present in women who did not conceive than in those who conceived. Infertile women who conceived had a shorter length of infertility before surgery than those who did not conceive. Conclusion(s) Laparoscopic colorectal resection is less likely to impact negatively on fertility than the laparotomy approach. Previous laparotomies, age ≥35 years, uterine adenomyosis, and longer duration of infertility before surgery are associated with decreased pregnancy rate.
ISSN:0015-0282
1556-5653
DOI:10.1016/j.fertnstert.2008.04.070