자궁내막증 환자에서 복강경수술 후 자연임신에 영향을 미치는 예측인자

Abstract

Objective: To identify the prognostic factors for predicting spontaneous pregnancy after laparoscopic surgical treatment of endometriosis. Methods: Retrospective analysis was performed in 82 patients who underwent elective laparoscopic surgery with subsequent pathological confirmation of the endometriosis at Gangnam Severance Hospital from January 2003 to March 2008. We investigated the spontaneous pregnancy rate during the 12 months following surgical treatment and administration of Gonadotropin-Releasing Hormone agonist (GnRH agonist). Factors associated with clinical characteristics, blood tests and operative findings were compared with pregnant and non-pregnant women. Results: The number of patients succeed to spontaneous pregnancy was 32 and failed to pregnancy was 50. Cumulative pregnancy rate was 39.02%. Mean pregnancy duration after surgical treatment was 5.96±3.43 months. r-AFS stage or grouping into two stages (mild/severe) (P=0.018), r-AFS score (P=0.008) and cul-de-sac obliteration (P=0.038) was significantly different between pregnant and non-pregnant group. Complete cul-de-sac obliteration was the independent factor of pregnancy failure in women with endometriosis after laparoscopic surgery. Conclusion: Complete cul-de-sac obliteration may be the important factors for predicting spontaneous pregnancy outcome in women with endometriosis after laparoscopic surgical treatment