DIE-Related Infertility: How We Can Improve the ReproductiveOutcomes

Background: To s tudy Pregnancy Rate (PR) in infertile patientswith Deep Infiltrated Endometriosis (DIE) after different types ofsurgery – shaving/discoid resection or segmental bowel resection.Materials and Methods: ۱۴۴ infertile patients ۲۰-۴۵ aged with DIE were operated in ۲۰۱۱-۲۰۱۸ years. All of them had typicalbowel symptoms, ۹۵ patients out of them were going to get pregnant.۵۱ patients who had shaving as surgery made the firs t group,۴۴ patients who had bowel resection made the second group.Results: Cumulative PR after surgical treatment of colorectalendometriosis made ۵۵.۷, ۵۴% (۲۹) out of them was spontaneouspregnancy, ۴۶% (۲۷) - after IVF. For the both groups SpontaneousPR was the same. More frequent Spontaneous Pregnancywas in ۲۰-۳۰ aged patients and more often after colorectalresection (۱۸% vs ۲۷%). Effectiveness of IVF was identical inboth groups (۲۵,۴% and ۲۵%). PR in ۳۶-۴۰ aged patients was۸%. Patients over ۴۰ didn’t have pregnancy.Conclusions: Surgery of DIE increased PR (spontaneous andIVF). However, the type of surgery (shaving or resection)doesn’t make any difference on reproductive outcome and dependson the patient age and their ovarian reserve, whether theyhave pains, bowel symptoms, failed IVF and previous endometriosissurgery. Bowel resection is preferable for ۲۰-۳۵ agedpatients ins tead of shaving.