LAPAROSCOPIC FINDINGS, TREATMENT AND REPRODUCTIVE OUTCOMES IN WOMEN WITH PRIMARY AND SECONDARY INFERTILITY
CANSAGE ePoster Library. Li-Yun-Fong R. 09/27/19; 275251; eP-118
Ryan Li-Yun-Fong
Ryan Li-Yun-Fong
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Abstract
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Objectives: To determine laparoscopic findings, treatment and reproductive outcomes in women with primary and secondary infertility.Methods: Prospective case series (June 2013-November 2014) at an academic affiliated hospital, involving 117 women with primary (n=74) and secondary (n=43) infertility. Patients underwent laparoscopy and treatment of pelvic disease, with median follow up of 5 years, and assessment of reproductive outcomes.Results: Median age and BMI of women with primary and secondary infertility were 33.4 vs 34.1 years, and 27.9 vs 28.6 kg/m2, respectively. Findings in primary vs secondary infertility included endometriosis [49/74 (66.2%) vs 21/43 (48.8%); p=0.10], adhesions without endometriosis [11/74 (14.9%) vs 9/43 (20.9%); p=0.56], other [7/74 (9.5%) vs 2/43 (4.6%); p=0.56; including PCOS] and no identifiable pathology [7/74 (9.5%) vs 11/43 (25.6%); p=0.04]. Twenty-one (17.9%) women were lost to follow. In women with primary infertility, pregnancy rates were for: endometriosis stages I/II – 11/24 (45.8%); stage III/IV - 8/25 (32.0%); adhesions - 4/11 (36.4%); other – 3/7 (42.9%); and normal pelvis - 4/7 (57.1%). In secondary infertility, corresponding rates were: endometriosis I/II - 2/7 (28.6%); III/IV - 10/14 (71.4%); adhesions - 5/9 (55.6%); other – 1/2 (50.0%); and normal pelvis – 4/11 (36.4%). Overall, 52/117 (44.4%) conceived after treatment; with 22/117 (18.8%) spontaneously; 26/117 (22.2%) using ART (IUI or IVF); and 4/117 (3.4%) unknown.Conclusions: In women with infertility, pelvic pathology was found and treated in 85% of cases, with endometriosis predominating (60%). Following treatment, the overall pregnancy rate was 44%. Therefore, laparoscopy should be considered in all women with infertility.
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