子宮内膜症合併不妊における腹腔鏡下手術後の妊娠予後の検討

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Objective: To evaluate the efficacy of laparoscopic surgery for endometriosis-associated infertility.Design: Retrospective study.Setting: Department of Obstetrics and Gynecology, Kochi Medical School.Patient(s): Sixty-five women with endometriosis-associated infertility.Intervention(s): Laparoscopic evaluation and treatment of endometriosis.Main outcome Measure(s): Background of 65 women with endometriosis-associated infertility. Clinical pregnancy rate (PR) of 57 women, who were followed > 6 months after laparoscopic surgery for endometriosis.Result: Of 57 women who underwent laparoscopic surgery, 34 conceived (clinical PR, 59.6%), including 28 non-ART pregnancies and 6 ART pregnancies. Eighty percent of non-ART pregnancies conceived within 1 year after laparoscopic surgery. In women with minimal and mild endometriosis, the clinical PR of non-ART after laparoscopic surgery was 61.1%, and in women with moderate and severe endometriosis the clinical PR of non-ART was 43.8%. The clinical PR of non-ART in women < 35 years of age (67.6%) was significantly higher than in older women (27.2%).Conclusion: Women with endometriosis-associated infertility can be expected to conceive spontaneously within 1 year after laparoscopic surgery. When patients fail to conceive 1 year after laparoscopic surgery, ART should be considered.
2010-12-01