A Study of Fertility Outcome and Recurrence between Laparoscopic Enucleation and Fulgration of Endometriotic cyst wall

Abstract

Objectives: The objective of this review was to determine which is the most effective technique for treating an ovarian endometrioma: either cystectomy by stripping of the cyst wall or drainage and fulgration of the cyst wall. Methods: We retrospectively studied 52 infertile women who underwent endometriotic cyst enucleation or drainage and fulgration of the cyst wall in AV Hospital between the year Jan 2010 to Dec 2011. They have been followed for 18 months after laparoscopy for conception. Results: The overall pregnancy rate among all the groups was 46.15 % (24/52) whereas 63% (21/33) among the cyst wall enucleation group conceived either spontaneously or thru ART whereas only 15%(3/19) conceived spontaneously in drainage and fulgration of the cyst wall group. The pregnancy rate for stage IV was relatively low 6.67%(3/45) compared to stage III. Again 21%(4/19) had recurrence after fulgration within 9 months of surgery as compared to 6%(2/33) of the cyst wall enucleation group. But as the number of patients with recurrence is small there is no statistical significance among the two groups. Conclusions: Laparoscopic excision by stripping method of the endometrioma was associated with a reduced rate of recurrence of the endometrioma and reduced rate of further surgery. It was also associated with an increase rate of subsequent pregnancy either spontaneously or by ART.