Effect of laparoscopy and hysteroscopy in infertility patients with endometriosis and endometrial polyps

Abstract

Objective To investigate the reproductive prognosis and its related factors in patients with endometriosis (EMS) complicated with endometrial polyps (EP) infertility treated by laparoscopy and hysteroscopy. Methods A retrospective analysis of 301 cases of EMS complicated with infertility treated by gynecology combined with laparoscopy in Fujian Maternity and Children Health Hospital from January 2014 to December 2014 was retrospectively analyzed. Based on whether the patient suffers from EP, the subjects were divided into EP group (n=129) and non-EP group (n=172). By comparing the efficacy of EP group with control group of 96 normally pregnant women, the effects of the operation were analyzed. Results The rate of contracting EP among patients suffering from EMS and infertility was 42.86% (129/301). In addition, patients with stage III and IV EMS had a higher probability of contracting EP than stage I and II patients (P=0.018). However, such significance disappeared when the comparison was drawn between stage I and stage II patients, as well as between stage III and IV patients. Patients with deep infiltrating EMS were more likely to contract EP (53.13%) than those suffering from ovarian or abdominal EMS (31.25%, P=0.014; 27.08%, P=0.003). The difference between these two types of diseases was not statistically significant. This group also had a higher embryo arrest rate (4.65%) than its negative counterpart (2.91%, P=0.028). Patients with peritoneal EMS combined with EP had a slightly higher probability of natural pregnancy than their ovarian or deep infiltrating counterparts, but the difference failed to achieve any statistical significance. The difference in the rate of pregnancy-induced complications and perinatal mortality between the EMS combined with EP group and control group was not statistically significant, yet the former did have a higher rate in receiving caesarean section, which was statistically significant (P=0.012). Conclusion Infertile patients suffering from EMS are likely to contract EP. Furthermore, infertile patients suffering from both EMS and EP should receive combined laparoscopic and hysteroscopic surgery as soon as possible to increase their chance of natural conception after surgery. The surgery is obviously effective in improving the reproductive prognosis of such patients, while at the same poses no risk of inducing pregnancy-related complications or affecting the neonatal outcomes. Key words: Endometriosis (EMS); Endometrial polyps (EP); Infertility; Surgery; Pregnancy