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. (Fertil Steril (R) 2011; 95: 1903-8. (C)2011 by American Society for Reproductive Medicine.)