Comparison of reoperation for moderate (stage III) and severe (stage IV) endometriosis-related infertility with in vitro fertilization-embryo transfer

Pagidas, Kelly; Falcone, Tommaso; Hemmings, Robert; Miron, Pierre

doi:10.1016/s0015-0282(16)58215-6

Cited by 115 publications

(49 citation statements)

References 15 publications

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“…In women with stage III/ IV endometriosis who have no known infertility factors, conservative surgical treatment with laparoscopy or laparotomy may increase fertility 52 . With respect to severe endometriosis, a nonrandomized study demonstrated that the cumulative pregnancy rates in 216 infertile patients followed for up to two years after laparoscopy or laparotomy were 49% and 63% respectively 53 . After the first infertility operation, additional surgery rarely increase fecundability and these patients are better served by assisted reproductive technology (ART) 54 .…”

Section: Treatment Of Endometriosis Associated Infertility Followingmentioning

confidence: 99%

Endometriosis - An Update

Banu

2014

J. Bangladesh Coll. Phys.

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Endometriosis is a common and important health problem of women. The prevalence of endometriosis is difficult to determine. Diagnosis is often difficult and delayed due to close similarity of symptoms of endometriosis with other gynecological disorder. Optimum treatment involves a combination of medical and surgical treatments tailored to the patient's needs and response.The objective of the study is to discuss the current updates on diagnosis, treatment and the optimal role of different options in the treatment of endometriosis. The article reviews different medical journals, medline and internet to get the relevant information. The study results showed that both medical and surgical treatments are almost equally effective in pain management there is no evidence that medical treatment improves fertility. Surgical treatment is associated with small but significant improvement in live birth rate. Newer non hormonal drugs are more selective with less metabolic side effects. Surgical treatment is invasive procedure and repeated surgery is associated with major complication.Medical treatment is considered more effective in the long term management of endometriosis. (J Banagladesh Coll

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Section: Treatment Of Endometriosis Associated Infertility Followingmentioning

confidence: 99%

Endometriosis - An Update

Banu

2014

J. Bangladesh Coll. Phys.

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“…Pagidas y col. compararon la reintervención con la FIV y concluyeron que la fecundación in vitro es mas efectiva, a pesar del éxito obtenido después de una nueva operación en la que se reporta una tasa del 20%, valor que no es despreciable (83). Fedele y col. compararon los resultados obtenidos de fertilidad después de la primera intervención con los de la segunda, encontrando una tasa de embarazo natural del 23,8% después de la primera y del 12,5% después de la reintervención.…”

Section: Tratamiento De Segunda Líneaunclassified

Endometriosis, endometrioma e infertilidad

Restrepo

2010

Rev. Med.

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ResumenLa endometriosis es una enfermedad ginecológica frecuente y puede ocasionar dolor pélvico; es una de las causas de infertilidad aunque en un pequeño pero significativo porcentaje y se observa hasta en el 50% de las laparoscopias de las pacientes en estudio de infertilidad. Sobre su patogénesis se conoce poco; sin embargo, actualmente existen varias teorías que tratan de explicar su presentación, sin obviar los factores genéticos que pueden hacer a las mujeres susceptibles a esta entidad. Los mecanismos que explican su fisiopatología en la infertilidad son la obstrucción tubárica, las adherencias pélvicas y los endometriomas ováricos que distorsionan las relaciones anatómicas y limitan el acceso y movilidad de las fimbrias al ovario. El método más utilizado para el diagnóstico de la endometriosis es la ecografía. Este artículo presenta una revisión de la literatura sobre la fisiopatología, la etiología, el cuadro clínico, el diagnóstico y el tratamiento de la endometriosis y los endometriomas en el área de la infertilidad. Palabras clave: endometrioma, infertilidad, endometriosis ENDOMETRIOSIS, ENDOMETRIOMA AND INFERTILITY AbstractEndometriosis is a common gynecological disease and can cause pelvic pain and infertility; although the latest represent a small but significant percentage of up to 50% of the testing female infertility using laparoscopy. Its pathogenesis is poorly understood though several theories are now offered which attempt to explain its appearance, such as genetic factors that could make women susceptible to this entity. The mechanisms that explain the pathophysiology of infertility are tubal blockage, pelvic adhesions and ovarian endometriomas distort anatomic relationships and limit access and mobility of the fimbriae to the ovary. The most widely used method for diagnosis of endometriomas is ultrasound. This article presents a literature review on the pathophysiology, aetiology, clinical manifestations, diagnosis and treatment of endometriosis and endometriomas in the area of infertility.

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“…Hier konnte gezeigt werden, dass bei voroperierten Patientinnen die IVF-Behandlung zu signifikant besseren Schwangerschaftschancen führt als eine erneute Operation [18]. In frühen Erkrankungsstadien ist der Vorteil einer IVF-Behandlung aber nach wie vor nicht gesichert.…”

Section: In-vitro-fertilisationunclassified

“…Hier gilt es, mit der Patientin gemeinsam Vor-und Nachteile abzuwägen, da die operative Sanierung zu einer weiteren Verminderung der ovariellen Reserve führen kann [28]. Bei Vorliegen eines Rezidivs einer ausgeprägten Endometriose ist die IVF einer erneuten operativen Therapie hinsichtlich der Schwangerschaftsrate überlegen (LOE III; [18]). …”

Section: Vorgehen Bei Endometriomenunclassified