Pregnancy Rate after Controlled Ovarian Hyperstimulation and Intrauterine Insemination for the Treatment of Endometriosis following Surgery

OBJECTIVE To compare pregnancy rate after controlled ovarian hyperstimulation and intrauterine insemination (COH-IUI) with no treatment in patients with endometriosis-associated infertility treated with laparoscopy. DESIGN A clinical cohort study. SETTING University-level tertiary care center. PATIENTS 238 women with various stages of endometriosis after laparoscopic treatment. INTERVENTIONS Either COH-IUI or follow-up for 12 months. MAIN OUTCOME MEASURES The primary outcome measures were clinical pregnancy and live birth rate. Predictive factors evaluated were female age, maternal BMI, and duration of infertility. RESULTS The pregnancy rate attained after the integrated laparoscopy-COH-IUI approach was 53.4%, while it was significantly lower (38.5%) in the control group. Similarly, a significant difference was observed in live births (48.3% versus 34.2%). Patients with severe endometriosis were less likely to achieve pregnancy (38%) and live birth (35%) than their counterparts with milder forms (57% and 53%). CONCLUSIONS In patients with endometriosis-based infertility, surgery followed by COH-IUI is more effective than surgery alone.