Fertility after colorectal resection for endometriosis: results of a prospective study comparing laparoscopy with open surgery

ObjectiveTo determine whether the surgical route of colorectal resection for endometriosis is a determinant factor for fertility.DesignProspective study.SettingTertiary-care university hospital.Patient(s)Fifty-two patients with endometriosis were randomly assigned to laparoscopic or open surgery.Intervention(s)Laparoscopically assisted vs. open colorectal resection.Main Outcome Measure(s)Evaluation of fertility outcomes spontaneously and after assisted reproductive therapy.Result(s)The mean follow-up was 29 months. Among the 28 patients wishing to conceive, 11 (39.3%) became pregnant. Overall cumulative pregnancy rate at 52 months for these patients was 45.1%. For patients with or without infertility, the cumulative pregnancy rate was 37.6% and 55.6%, respectively, and the cumulative spontaneous pregnancy rate 13.3% and 36.5%, respectively. All the spontaneous pregnancies were observed in the laparoscopy group.Conclusion(s)This study demonstrates that spontaneous pregnancy is more frequent after laparoscopy compared with open surgery for colorectal endometriosis.