Role of Laparoscopy in Diagnosis and Treatment of Endometriosis Associated with Infertility: A Prospective Analysis

Abstract

Objective: Endometriosis is often considered as an enigma due to its varied clinical presentation and challenges in diagnosis. The objective of this study is to evaluate the role of laparoscopy in diagnosis and treatment of endometriosis associated with infertility.Materials and Methods: Infertile females diagnosed to have endometriosis during or before undergoing laparoscopic surgery from August 2018 to February 2020 were followed up for spontaneous conception for 6 months following laparoscopy. Revised American Fertility Society (r-AFS) scoring system was used to score endometriosis and stage the disease (stage I-IV). Surgical interventions were done on individual cases basis following ESHRE guidelines.Results: Fifty infertile females diagnosed with endometriosis during or before laparoscopy were recruited for the study. Mean age of patients was 28.58 (±4.21) years. Thirty-four (68%) patients had primary infertility and 16 (32%) has secondary infertility. Mean duration infertility was 3.33 (±1.43). Only 37 patients (74%) had evidence of endometriosis in pre-operative ultrasonography. During the follow up period of first 6 months after surgery 34 (68%) patients conceived spontaneously. Lower mean endometriosis score (p=0.00) and early stage of endometriosis (p=0.00) were associated with higher chances of conception. But, female age, duration and type infertility, USG findings, and type of surgical interventions did not affect pregnancy rate.Conclusion: Laparoscopy helps in diagnosis of endometriosis. Laparoscopic therapeutic interventions for endometriosis increase the probability of spontaneous conception in infertile females. Lower surgical score and early stages of endometriosis are associated with higher chance of conception.