TITLE:
Management of Infertility in Endometriosis by Operative Laparoscopy and Medical Therapy—Practiced at 3 Different Centres, from September 2005 to October 2007
AUTHORS:
Pratibha Devabhaktuni, Swathi Gogineni, Savitha Devi Yalamanchi, Anuradha Katragadda
KEYWORDS:
Endometriosis, Infertility, Conceptions, Ovulation Induction
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.9 No.6,
June
3,
2019
ABSTRACT: This is a prospective study conducted over a period of 2 years and 1
month (from September 2005 to October 2007).
60/117 (52.17%) patients who had laparoscopy for infertility at GMH had
endometriosis. 60 patients operated for endometriosis at SHC and 40 patients
managed at Anu Infertility Centre during the same period are also included in
this study. All the 60 patients underwent operative laparoscopy for endometriosis.
Adhesiolysis, electrocautery of surface endometriosis of the ovary, enucleation
of endometriotic cyst, mobilization of ovary from uterus and pouch of
Douglas and restoration of normal anatomy were carried out. Treatment
interventions: Therapeutic hysteroscopy and laparoscopy, medical treatment by
various ovulation induction protocols, monitoring by follicular sonography
followed by pregnancy management were done in these women. Results: GMH—Seventeen 17 out of 18 coming for follow up conceived, 14 following
ovulation induction and 3 after COH + IUI, by
one year at GMH. SHC—14 out of 18 patients coming for follow up at
the end of one year conceived, following
ovulation induction 6, COH + IUI-3, IVF-3 and spontaneous 2. ANU—Out of 11 conceptions, COH + IUI
resulted in 6, IVF in 4, spontaneous in 1—by one year. Pregnancy
outcome: GMH: Ten delivered, Triplets in one, missed
abortion two, emergency laparotomy in one. Pregnancy is continuing in 4. SHC:
Eight patients delivered. Pregnancy is continuing in 4 patients. Ectopic-1,
missed abortion-1. ANU: Five patients delivered. Pregnancy is continuing in 3 women, missed
abortion-2, second trimester abruption-1. Discussion: The conception rate was 50% at the end of 6 months
follow up