Reproductive aspects in the treatment of colorectal endometriosis

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OBJECTIVES

To compare the effectiveness of in vitro fertilization (IVF) as first and second line treatment for infertility in colorectal endometriosis. As well as gather evidence to support the validity for own oocyte/embryo banking before to surgical intervention in women with concomitant endometriotic ovarian cysts.

MATERIAL AND METHODS

Frequency pregnancy rates per ovarian stimulation and embryo transfer were evaluated in 96 infertile patients with colorectal endometriosis. The analysis of the IVF outcome was carried out depending on the timing of the operation performed. The results obtained were compared with the ovarian reserve (AMH level) and the presence of concomitant pathologies: endometrioid ovarian cysts and endometrial hyperplasia.

RESULTS

A veraciously decreasing marks in ovarian stimulation and embryo transfer was observed when IVF was initiated more than 6 months after surgical treatment for colorectal endometriosis. The observed correlation of poor ovarian response may be explained by a decrease in ovarian reserve and a higher incidence of endometrial hyperplasia late postoperatively. The majority of women were found to have endometrioid ovarian cysts again, which often required re-excision of the cyst due to persistent recurrence after surgical treatment of colorectal endometriosis.

CONCLUSION

Based on these findings, in infertile women with colorectal endometriosis it is preferable to perform IVF either before surgical treatment or within a short timeframe (not surpassing 6 months) after surgery. In cases where the realization of reproductive plans is delayed, it is advisable to recommend oocyte/embryo banking due to the high likelihood of recurrent endometriosis and decrease associated ovarian reserve.

Keywords:

infertility

colorectal endometriosis

ovarian reserve

in vitro fertilization (IVF)

Authors:

Krasnopolskaya K.V.

Krasnopolsky Moscow Regional Research Institute of Obstetrics and Gynecology

ORCID: 0000-0002-1275-9220

Ershova I.Yu.

Krasnopolsky Moscow Regional Research Institute of Obstetrics and Gynecology

ORCID: 0000-0001-9327-0656

Isakova K.M.

Krasnopolsky Moscow Regional Research Institute of Obstetrics and Gynecology

ORCID: 0000-0001-6194-1654

Troshina V.V.

Krasnopolsky Moscow Regional Research Institute of Obstetrics and Gynecology

ORCID: 0000-0002-1873-5676

Received:

30.07.2023

Accepted:

01.03.2024

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