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

Objective To determine whether the surgical route of colorectal resection for endometriosis is a determinant factor for fertility. Design Prospective study. Setting Tertiary-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.