1748 Fertility and Surgical Outcome in Postoperative Deep Infiltrating Endometriosis

Abstract

Study Objective To analyze clinical characteristics and fertility outcome in postoperative deep infiltrating endometriosis. Design Retrospective cohort study. Follow-up of about 27 months. Setting Tertiary-care university medical center. Patients or Participants 55 patients of productive age who were diagnosed of deep infiltrating endometriosis (DIE), undergone resection surgery and wished to conceive in our hospital from January 2009 to June 2017. Any plausible infertility factor or abnormality of partner's semen analysis were excluded. Interventions Clinical characteristics, fertility and surgical outcome were followed up and analyzed. Measurements and Main Results There were 34 pregnancies (61.82%) with 24 (70.59%) spontaneously and 10 (29.41%) in-vitro fertilization (IVF). 28 patients (82.35%) were term deliveries. The interval between operation and pregnancy was 10.33±5.6 (1-26) months. The pregnancy group had higher EFI (endometriosis fertility index, EFI) scores and more patients had cautery procedure in non-pregnancy group(p Conclusion In our study, the postoperative pregnancy rate of DIE is 61.82%. Surgical management for DIE patients with painful complaints and pregnancy intention were feasible and effective. Once surgery is decided, complete excision of DIE could be the first choice. For incomplete excision cases, administration of postoperative GnRHa is suggested. Postoperative IVF-ET may be a good choice for the patient with lower EFI score (EFI