Infertile Women with Deep and Intraperitoneal Endometriosis: Comparison of Fertility Outcome According to the Extent of Surgery

Study Objective: This study was undertaken to ascertain whether the incidence of spontaneous pregnancy is increased in infertile women with deep and intraperitoneal endometriosis undergoing extensive surgery compared with those undergoing only intraperitoneal surgery. Design: Retrospective case control study (Canadian Task Force classification II-1). Setting: University teaching hospital. Patients: Infertile women under the age of 40 years with deep and intraperitoneal endometriosis and no other associated major infertility factors. Only patients with at least 1 year of postoperative follow-up were included. Interventions: Intraperitoneal surgery only (group I) or extensive surgery (group 2) according to a shared decision-making approach. Measurements and Main Results: Among the 34 women in group 1, 6 became pregnant, compared with 8 of the 41 women who had extensive surgery (12-month cumulative probabilities, 24.8% and 11.4%, respectively, and 24-month cumulative probabilities, 24.8% and 23.2%, respectively; p = .82). Perioperative surgical complication rate was higher in group 2 (6/41 versus 0/34; p = .02). Conclusion: Extensive surgery for intraperitoneal and deep endometriosis in infertile women does not modify global fertility outcome but is associated with a higher complication rate. Journal of Minimally Invasive Gynecology (2011) 18, 622-628 (C) 2011 AAGL. All rights reserved.