Influence of pelvic endometriosis and ovarian endometrioma on fertility. 2002

Akira Fujishita, and Khaleque Newaz Khan, and Hideaki Masuzaki, and Tadayuki Ishimaru
Department of Obstetrics and Gynecology, Nagasaki University School of Medicine, Nagasaki, Japan. fujishita@net.nagasaki-u.ac.jp

We investigated the influence of pelvic endometriosis and ovarian endometrioma on pregnancy outcome in women associated with infertility. A total of 237 women with endometriosis were reviewed, and their fertility rate was assessed by both r-AFS staging and TOP classification as previously proposed by our group. There was no significant difference in pregnancy rate among r-AFS stages. However, the pregnancy rate was mostly affected by the tubal condition according to the TOP classification as follows: no adhesive lesion (T0), 53% (69/129); unilateral lesion (T1), 46% (18/39); bilateral lesion with at least one tube patent, (T2), 37% (10/27); bilateral tubal occlusion (T3), 0% (0/8) (p < 0.05, Mantel-Extension test). The absence (O0-O1) or co-existence (O2-O3) of ovarian endometrioma and different gradings of cul-de-sac obliteration (P2-P3) showed no significant differences in pregnancy rate. The resulting conception rate was also not affected by the size or location of ovarian endometrioma. In addition, the higher adhesion score of ovarian endometrioma involving the fallopian tube and as described in r-AFS classification had a significant detrimental effect on fertility. These observations suggest that our TOP classification describing individual tubal condition has a clinically predictive value in assessing the reproductive outcome of women with endometriosis.

UI MeSH Term Description Entries
D007247 Infertility, Female Diminished or absent ability of a female to achieve conception. Sterility, Female,Sterility, Postpartum,Sub-Fertility, Female,Subfertility, Female,Female Infertility,Female Sterility,Female Sub-Fertility,Female Subfertility,Postpartum Sterility,Sub Fertility, Female
D010049 Ovarian Diseases Pathological processes of the OVARY. Disease, Ovarian,Diseases, Ovarian,Ovarian Disease
D010051 Ovarian Neoplasms Tumors or cancer of the OVARY. These neoplasms can be benign or malignant. They are classified according to the tissue of origin, such as the surface EPITHELIUM, the stromal endocrine cells, and the totipotent GERM CELLS. Cancer of Ovary,Ovarian Cancer,Cancer of the Ovary,Neoplasms, Ovarian,Ovary Cancer,Ovary Neoplasms,Cancer, Ovarian,Cancer, Ovary,Cancers, Ovarian,Cancers, Ovary,Neoplasm, Ovarian,Neoplasm, Ovary,Neoplasms, Ovary,Ovarian Cancers,Ovarian Neoplasm,Ovary Cancers,Ovary Neoplasm
D010535 Laparoscopy A procedure in which a laparoscope (LAPAROSCOPES) is inserted through a small incision near the navel to examine the abdominal and pelvic organs in the PERITONEAL CAVITY. If appropriate, biopsy or surgery can be performed during laparoscopy. Celioscopy,Laparoscopic Surgical Procedures,Peritoneoscopy,Surgical Procedures, Laparoscopic,Laparoscopic Assisted Surgery,Laparoscopic Surgery,Laparoscopic Surgical Procedure,Procedure, Laparoscopic Surgical,Procedures, Laparoscopic Surgical,Surgery, Laparoscopic,Surgical Procedure, Laparoscopic,Celioscopies,Laparoscopic Assisted Surgeries,Laparoscopic Surgeries,Laparoscopies,Peritoneoscopies,Surgeries, Laparoscopic,Surgeries, Laparoscopic Assisted,Surgery, Laparoscopic Assisted
D011237 Predictive Value of Tests In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test. Negative Predictive Value,Positive Predictive Value,Predictive Value Of Test,Predictive Values Of Tests,Negative Predictive Values,Positive Predictive Values,Predictive Value, Negative,Predictive Value, Positive
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D011256 Pregnancy Outcome Results of conception and ensuing pregnancy, including LIVE BIRTH; STILLBIRTH; or SPONTANEOUS ABORTION. The outcome may follow natural or artificial insemination or any of the various ASSISTED REPRODUCTIVE TECHNIQUES, such as EMBRYO TRANSFER or FERTILIZATION IN VITRO. Outcome, Pregnancy,Outcomes, Pregnancy,Pregnancy Outcomes
D011336 Probability The study of chance processes or the relative frequency characterizing a chance process. Probabilities
D011379 Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D004715 Endometriosis A condition in which functional endometrial tissue is present outside the UTERUS. It is often confined to the PELVIS involving the OVARY, the ligaments, cul-de-sac, and the uterovesical peritoneum. Endometrioma,Endometriomas,Endometrioses

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