Comparison of Fecundity after Second Laparotomy for Endometriosis to in Vitro Fertilization and Embryo Transfer
Sopon Cheewadhanaraks MD*
Affiliation : * Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University
Objective : To study the prognosis for conception subsequent to a second conservative laparotomy for
infertile patients with moderate and severe endometriosis, compared with the reproductive outcome of one
cycle of in vitro fertilization and embryo transfer (IVF-ET).
Materials and Methods : From January 1990 to February 2000, 190 infertile patients had initial conservative
laparotomy for pelvic endometriosis at a university hospital. All of these patients had moderate or severe
endometriosis. After the failure of the initial operation to restore fertility, 32 patients requested the second
operation while 24 patients underwent one cycle of IVF-ET. The cumulative pregnancy rate after the second
operation was compared with the clinical pregnancy rate after one cycle of IVF-ET.
Result : The cumulative pregnancy rate following the reoperation was 20.5% within 1 year with no addi-
tional increase in 2 and 3 years of follow up. The clinical pregnancy rate per stimulation of one cycle of IVF-
ET was 12.5%. There was no statistically significant difference (P = 0.54).
Conclusion : Despite a trend toward a higher cumulative pregnancy rate following the second conservative
laparotomy, there was no statistically significant difference, when compared with one cycle of IVF-ET in
moderate and severe endometriosis-associated infertile patients who had not conceived after the initial
operation.
Keywords : Endometriosis, Infertility, In vitro fertilization and embryo transfer, Surgery
