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Fertility and Infertility in Patients with Bowel Endometriosis

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Clinical Management of Bowel Endometriosis

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Abstract

Bowel endometriosis is typically associated with deep endometriotic lesions in the pelvis and endometriomas, making it difficult to establish the precise impact of intestinal endometriotic lesions on fertility. Very limited data are available on rates of spontaneous conception in women with bowel endometriosis. Infertile patients with bowel endometriosis may either undergo surgery to enhance fertility or artificial reproductive techniques (ART) such as in vitro fertilization (IVF). Interpretation of the available data on fertility outcomes after colorectal surgery for deep endometriosis is difficult as the overall quality of the studies is poor. Furthermore, several studies do not distinguish patients with real infertility from those wishing to conceive without proven infertility. Patients with bowel endometriosis undergoing ART must be informed of the potential risks (e.g., bowel complications such as perforation and severe infection) during oocyte retrieval and pregnancy. Persistence of pelvic pain, intestinal symptoms due to delaying surgery as well as the progression of the degree of intestinal wall infiltration are well recorded. However, ART has some advantages in women with bowel endometriosis because it shortens the interval to conception and avoids the negative impact of postoperative complications (such as anastomotic leakage or deep pelvic abscess) on fertility. It is well established that bowel surgery leads to relief of pain and intestinal symptoms caused by endometriotic lesions. In contrast, the usefulness of bowel surgery to increase the likelihood of spontaneous conception is yet to be established.

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Author information

Authors and Affiliations

  1. Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genova, Italy

    Simone Ferrero

  2. Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genova, Genova, Italy

    Simone Ferrero

  3. Hôpital Privé Natecia, Lyon, France

    Antoine Watrelot

  4. London, UK

    Gedis Grudzinskas

Authors
  1. Simone Ferrero
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  2. Antoine Watrelot
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  3. Gedis Grudzinskas
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Correspondence to Gedis Grudzinskas .

Editor information

Editors and Affiliations

  1. Division of Obstetrics and Gynaecology, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genova, Genova, Italy

    Simone Ferrero

  2. Department of Obstetrics and Gynaecology, Gynecologic Oncology and Minimally-Invasive Pelvic Surgery, International School of Surgical Anatomy, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy

    Marcello Ceccaroni

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Ferrero, S., Watrelot, A., Grudzinskas, G. (2020). Fertility and Infertility in Patients with Bowel Endometriosis. In: Ferrero, S., Ceccaroni, M. (eds) Clinical Management of Bowel Endometriosis. Springer, Cham. https://doi.org/10.1007/978-3-030-50446-5_17

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  • DOI: https://doi.org/10.1007/978-3-030-50446-5_17

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-50445-8

  • Online ISBN: 978-3-030-50446-5

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