Pregnancy and recurrence rates in infertile patients operated for ovarian endometriosis.
Rev Med Chir Soc Med Nat Iasi
; 119(1): 127-34, 2015.
Article
em En
| MEDLINE
| ID: mdl-25970955
ABSTRACT
AIM:
The study deals with the preoperative ultrasound diagnosis of ovarian endometriosis, postoperative ultrasound reassessment, laparoscopic surgical resolution of ovarian endometriosis, estimation of recurrence risk 12 months after surgery by ultrasound, reappearance of clinical symptoms (such as pain) or second-look laparoscopy, and pregnancy rate 2 years after surgery. MATERIAL ANDMETHODS:
140 patients with en- dometriosis and infertility admitted to the Iasi "Cuza-Voda" Clinical Hospital of Obstetrics and Gynecology between the years 2009-2011 were included in the study. The patients were divided into 2 groups group 1-59 cases that refused in vitro fertilization procedures, did not afford in vitro fertilization (IVF) or had minimal endometriosis and young ages and thus a possibility of delaying treatment, and group 2--62 cases which underwent IVF procedures immediately after surgery.RESULTS:
No significant differences in the chance of becoming pregnant were found between the two groups (χ2 = 2.06, p = 0.0891, 95% CI); in group 1, 11.86% pregnancies were obtained while in group 2 the pregnancy rate was 11.29%. Based on the nonparametric method of analysis of contingency tables we could estimate the odds of becoming pregnant in the study groups, obtaining an odds ratio (OR = 1.16, CI 1.04-2.23, 95% CI). This result indicated that in group 1 the odds of becoming pregnant was not significantly higher, and the estimation was made for a confidence interval of 95%. The study had in view the assessment of pregnancies obtained in the study groups and the time interval (number of weeks) from the time of intervention until the occurrence of pregnancy. The Kaplan-Meier analysis enabled the assessment of the mean value and the median value of the number of weeks until becoming pregnant, and these values did not show significant differences (χ2 = 1.55, p = 0.212, 95% CI).CONCLUSIONS:
For endometriosis associated with infertility, hormonal suppression does not improve fertility, and therefore surgery followed by controlled ovarian hyperstimulation and intrauterine insemi- nation (IUI), provided the anatomy of the pelvis is preserved in early cases or in vitro fertilization in severe cases is preferred.
Buscar no Google
Base de dados:
MEDLINE
Assunto principal:
Indução da Ovulação
/
Fertilização in vitro
/
Taxa de Gravidez
/
Infertilidade Feminina
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Pregnancy
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article