Effect of delaying post-operative conception after conservative surgery for endometriosis.

The objective of this study was to determine whether delaying attempts to conceive after surgery for endometriosis impacts on reproductive prognosis. Patients operated on for endometriosis who were not seeking pregnancy at the time of surgery were selected (n=124) from a large survey regarding reproductive outcome of women with the disease. Pregnancy rate and rate of second surgery were compared between women who attempted conception within 12 months after surgery (n=61) and those compared who postponed attempts for 12 months or more (n=63).

The second time around: reproductive performance after repetitive versus primary surgery for endometriosis.

After repetitive surgery for recurrent endometriosis, 20 of 89 (22%) women achieved spontaneous pregnancy, compared with 165 of 411 (40%) after first-line procedure (adjusted incidence rate ratio, 0.51; 95% confidence interval, 0.32 to 0.

The use and effectiveness of in vitro fertilization in women with endometriosis: the surgeon's perspective.

Objective: To assess the use and effectiveness of IVF in a cohort of women undergoing surgery for endometriosis.

Design: Cohort study.

Setting: University hospital.

Postoperative oral contraceptive exposure and risk of endometrioma recurrence.

Objective: The purpose of this study was to compare the postoperative risk of endometrioma recurrence in women using oral contraception and in those undergoing simple observation.

Study Design: After laparoscopic excision of ovarian endometriotiomas, a cyclic, low-dose, monophasic oral contraceptive pill (OCP) was offered to women not seeking pregnancy. One month after surgery, and every 6 months afterward, the patients underwent clinical and ultrasonographic assessment.

Endometriosis: current and future medical therapies.

Endometriosis is a chronic inflammatory disease that responds to steroidal manipulation. Creation of a steady hormonal environment with inhibition of ovulation temporarily suppresses the ectopic implants and reduces the inflammatory status as well as the associated pain symptoms. Pharmacological management of endometriosis must be set within the framework of long-term therapeutic strategies.

Asymmetric lateral distribution of obstructed hemivagina and renal agenesis in women with uterus didelphys: institutional case series and a systematic literature review.

Objective: To investigate if an asymmetry exists in the lateral distribution of obstructed hemivagina and renal agenesis in women with uterus didelphys.

Design: All English-language medical papers on uterus didelphys, obstructed hemivagina, and associated renal agenesis published from 1980 to 2005 and identified by Embase, Medline, and Pubmed database searches were retrieved. In addition, 41 institutional cases are described.

Reproductive performance in infertile women with rectovaginal endometriosis: is surgery worthwhile?

Objective: This study was undertaken to ascertain whether the incidence of pregnancy is increased and time-to-conception is reduced in infertile women with rectovaginal endometriosis undergoing conservative surgery compared with those on expectant management.

Study Design: A total of 105 infertile women under the age of 40 years with rectovaginal endometriosis and no other associated major infertility factor underwent first-line conservative surgery at laparotomy or expectant management according to a shared decision-making approach.

Results: Among the 44 women who had resection of rectovaginal endometriosis, 15 became pregnant, compared with 22 of the 61 women who choose expectant management (24-month cumulative probabilities, 44.

Adenomyosis: epidemiological factors.

Epidemiological studies of adenomyosis are difficult to interpret because the diagnostic criteria vary so widely that the disease may be easily over-diagnosed. This would severely hamper any attempt to define incidence and prevalence of the condition and the related risk factors, and would limit the possibility of clarifying to what extent adenomyosis contributes to clinical symptoms. There is a need for stringent and widely accepted diagnostic criteria in order to define not only the presence of adenomyosis but also depth of penetration and degree of spread of foci.