Unilateral versus bilateral adnexal disease in stage III and stage IV endometriosis does not affect pregnancy outcome after operative laparoscopy

To study the effect of unilateral versus bilateral adnexal involvement on the pregnancy rate after operative laparoscopy. Historic cohort study. A total of 143 patients with advanced stages of endometriosis (stage III and IV) who underwent operative laparoscopy for infertility treatment were categorized into those with unilateral versus bilateral adnexal disease. Forty-three patients had primarily unilateral (group 1) and 100 had bilateral disease (group 2). Follow-up was up to 2 years. There was no significant difference between group 1 and group 2 with respect to pregnancy rates (28% vs 31%), delivery rates (21% vs 23%), miscarriage rates (25% vs 13%), and ectopic rates (0% vs 13%). Cumulative conception rates after up to 24 cycles of natural intercourse and up to three IUI cycles were 59% and 49% for group 1 and group 2, respectively. Operative laparoscopy for advanced stages of endometriosis appears to be an effective treatment modality for establishing a pregnancy in infertile patients. Pregnancy and delivery rates are not different in patients with unilateral or bilateral adnexal involvement.