The benefit of adenomyomectomy on fertility outcomes in women with rectovaginal endometriosis with coexisting adenomyosis.
作者信息
Kishi Yohei, Yabuta Maki
机构信息
Department of Obstetrics and Gynecology, Nara Medical University, Nara, Japan.
Department of Obstetrics and Gynecology, Takanohara Central Hospital, U-Kyo 1-3-3, Nara 631-0805, Japan.
出版信息
Gynecol Minim Invasive Ther. 2017 Jan-Mar;6(1):20-24. doi: 10.1016/j.gmit.2016.08.002. Epub 2016 Sep 16.
STUDY OBJECTIVE
To evaluate the effect of removal of coexisting adenomyosis on fertility outcomes in women with rectovaginal endometriosis.
DESIGN
A retrospective cohort study.
SETTING
A general hospital.
PATIENTS
A total of 190 women who underwent laparoscopic nodule excision surgery for rectovaginal endometriosis between April 2007 and December 2012.
INTERVENTIONS
Surgical excision of the rectovaginal endometriosis and coexisting uterine adenomyosis. Statistical analysis for fertility outcomes.
MEASUREMENT AND MAIN RESULTS
A total of 119 women desired postoperative pregnancy. Coexisting adenomyosis was found in 21% of the women. The overall clinical pregnancy rate was 41.2%. The only determining factor associated with a successful pregnancy was "age at surgery". Clinical pregnancy rates with or without adenomyosis were 36.0% and 42.6%, respectively. We found no significant difference in clinical pregnancy rates between the groups.
CONCLUSION
There is a possibility that surgical removal of coexisting adenomyosis positively effects fertility outcomes in women with rectovaginal endometriosis. However, it is also important to note that the age at surgery was a critical factor for successful pregnancy.
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