section name header

Evidence summaries

Laparoscopic Surgery for Subfertility Associated with Endometriosis

The use of laparoscopic surgery in the treatment of endometriosis appears to improve pregnancy success rates. Level of evidence: "B"

A Cochrane review cd011031 (abstract , review [Abstract]) included 3 studies with a total of 535 subjects. Compared with diagnostic laparoscopy, laparoscopic surgery was associated with an increased viable intrauterine pregnancy confirmed by ultrasound (OR 1.89, 95% CI 1.25 to 2.86; 3 RCTs, n=528).

A retrospective cohort study 2 included all women (n=78) who failed IVF treatment before surgery and who underwent laparoscopic surgery for severe endometriosis between January 2006 and December 2014. After surgical treatment 33 women (42.3%) delivered. Three women (9%) conceived spontaneously and all other women conceived after IVF treatment. In addition, performing salpingectomy during surgery was associated with a trend of improvement in delivery rates after surgery (70% in women who delivered vs. 51% in women who failed to deliver).

Comment: The quality of evidence is downgraded by imprecise results (few outcome events).

References

  • Bafort C, Beebeejaun Y, Tomassetti C et al. Laparoscopic surgery for endometriosis. Cochrane Database Syst Rev 2020;(10):CD011031. [PubMed]
  • Soriano D, Adler I, Bouaziz J et al. Fertility outcome of laparoscopic treatment in patients with severe endometriosis and repeated in vitro fertilization failures. Fertil Steril 2016;106(5):1264-1269. [PubMed]

Primary/Secondary Keywords