子宮内膜症を有する不妊症に対する腹腔鏡下手術の検討 Retrospective analysis of infertile women with endometriosis who underwent laparoscopic surgery

Objective: To determine the pregnancy rate after laparoscopic surgery on infertile women with endometriosis.Design: The pregnancy outcomes of 379 infertile women with endometriosis after laparoscopic surgery was followed for 9 months and retrospectively analyzed. Results: One hundred sixty-two patients (42.7%) conceived, as follows: spontaneous, 34; timed intercourse, 47; intrauterine insemination, 26; and assisted reproductive techniques (ART), 54. The cumulative pregnancy rate in patients with stage IV endometriosis (30.6%) was lower than patients with stage I endometriosis (43.1%) 18 months after laparoscopy. The cumulative pregnancy rate was 30.3% in all patients, and 23.2% in patients excluding ART pregnancies, 12 months after laparoscopy. Seventy percent of pregnant women conceived within 12 months. The pregnancy rate within 12 months with ART was 50%, whereas the pregnancy rate without ART technology was 80%-90%. Conclusion: Our findings suggest that treatment, such as observation, timed intercourse, and intrauterine insemination, should be performed for infertile women with endometriosis up to 12 months after laparoscopic surgery.