Pregnancy rates following ablative laparoscopic surgery for endometriomas

K.D.Jones, C.J.G.Sutton

Human Reproduction Vol.17, No.3 pp. 782–785 (2002)

BACKGROUND: In this prospective, cohort study we present the cumulative pregnancy rate following ablative laparoscopic surgery in patients with endometriomas.

METHODS: The cyst was mobilized, fenestrated, and the capsule treated with the potassium–titanyl–phosphate (KTP) laser or bipolar diathermy. Pre- and post-operative transvaginal ultrasound scans were performed, and a detailed fertility history recorded.

RESULTS: There were 39 women (38 intention to treat as a single procedure) who had been trying to conceive for >12 months. The mean age of the patients was 33.8 years (range 20–43), and there were 42 cysts (three bilateral) with a mean diameter of 4.8 cm (range 2–25). The mean revised American Fertility Society score was 64.9 (range 22–124), and 29 (74.4%) patients had stage IV disease. Seven patients (18%) had previously had a live birth, and 17 (43.6%) had undergone assisted conception in the past. The cumulative pregnancy rate was 15/38 (39.5%). The pregnancy rate in patients with stage IV disease was 11/28 (39.3%). There were no major complications.

CONCLUSIONS: Our results indicate that laparoscopic cyst fenestration and capsule ablation is a safe and effective treatment for improving fertility.