Value of Early Laparoscopic Exploration for Primary Infertile Patients with Patent Fallopian Tubes Complicated with Pelvic Effusion

• Published in: Medical science monitor 2022-12, Vol.28, p.e938637-e938637
• Main Authors: Tang, Jiexin, Wang, Zhilin, Lu, Danhua, Xie, Yucen, Zhang, Dan
• Format: Article
• Language: English
• Subjects: Clinical Research; Endometriosis - complications; Endometriosis - pathology; Endometriosis - surgery; Fallopian Tube Diseases - complications; Fallopian Tube Diseases - diagnosis; Fallopian Tube Diseases - surgery; Fallopian Tubes - pathology; Fallopian Tubes - surgery; Female; Humans; Infertility, Female - surgery; Laparoscopy - adverse effects; Menstruation Disturbances - complications; Menstruation Disturbances - pathology; Menstruation Disturbances - surgery; Pregnancy; Retrospective Studies; Tissue Adhesions - pathology
• ISSN: 1643-3750; 1234-1010; 1643-3750
• DOI: 10.12659/MSM.938637

BACKGROUND Endometriosis is a progressive disease, and early detection and early treatment are particularly important. The purpose of this study was to investigate the effect of the timing of laparoscopy on the spontaneous pregnancy rate of primary infertile patients complicated with pelvic effusion within 6 months after surgery. MATERIAL AND METHODS We enrolled 330 primary infertile patients with pelvic effusion and bilateral patent fallopian tubes. They were divided into 3 groups based on retrospective analysis of clinical data. Study Group 1 underwent laparoscopy 1 month after hysterosalpingography (HSG), Study Group 2 received laparoscopy after trying to conceive for 3 months, and the Control Group did not undergo laparoscopy. According to the specific conditions during laparoscopy, repair and plastic surgery of fallopian tube, electrocautery of endometriosis and uterine suspension were performed. The main observation indicators were proportions of retrograde menstruation, peritoneal endometriosis, and tubal adhesions in laparoscopy groups, and spontaneous pregnancy rates within 6 months. RESULTS The proportions of retrograde menstruation were 92.2% and 93.1% in Study Group 1 and Study Group 2, respectively, with no statistical significance. The proportions of peritoneal endometriosis were 51.0% and 64.7%, with a statistically significant difference. The proportions of tubal adhesions were 31.4% and 36.2%, with no statistical significance. The pregnancy rates within 6 months were 73.9%, 52.6%, and 13.1%, with a statistically significant difference for pairwise comparisons. CONCLUSIONS The pregnancy rate of primary infertile patients with patent fallopian tubes complicated with pelvic effusion can be significantly improved through early laparoscopic surgery (exploration and treatment).