Fertility Outcome of Laparoscopic Treatment in Patients with Endometriosis

Abstract

Background
Endometriosis is a chronic estrogen-dependent condition causing infertility through pelvic inflammation, anatomical distortion, and impaired endometrial function. Laparoscopy is the gold standard for diagnosis and treatment, with proven fertility benefits in high-resource settings. However, data from low-resource contexts like Nepal are limited. This study aims to evaluate fertility outcomes following laparoscopic management of endometriosis among reproductive-age women in a tertiary hospital in eastern Nepal.

Methods
A descriptive cross-sectional study was conducted at Birat Medical College Teaching Hospital, Nepal, from January to December 2024, involving 22 women with laparoscopically confirmed endometriosis who underwent treatment during diagnostic hysterolaparoscopy for subfertility. Of these, 11 women were successfully contacted, consented, and provided information on their fertility outcomes, forming the final study sample. Women with comorbidities affecting fertility or those lost to follow-up were excluded. Data were collected from hospital records and telephone interviews conducted at least one year after surgery. Descriptive statistics were used for data analysis.

Results
Among the 104 women who underwent diagnostic hysterolaparoscopy for subfertility, 22 were diagnosed and treated for endometriosis. Eleven women responded to follow-up and were included in the final analysis. The participants had a mean age of 31.7 years, with most belonging to Janajati ethnicity. Following laparoscopic surgery, 2 women (18.2%) achieved conception and live birth via in-vitro fertilization (IVF), both delivered by cesarean section. The remaining 9 participants had not conceived at the time of follow-up. 

Conclusions
Laparoscopic management of endometriosis shows promising fertility outcomes, supporting its value in fertility care even in resource-limited settings.