Outcome of Laparoscopic Versus Open Surgery in The Management of Endometriosis Related Infertility

Open Access

Abstract

Introduction: Endometriosis is a common gynaecological disorder and an important cause of female infertility, often impairing reproductive function through pelvic adhesions, and chronic inflammation etc. Surgical treatment plays a key role in restoring pelvic anatomy and improving fertility, with laparoscopic and open surgery being the two principal approaches. The present study was conducted to compare the outcomes of laparoscopic versus open surgery in the management of endometriosis-related infertility. Methods & Materials: This retrospective comparative study was conducted in the Department of Obstetrics and Gynaecology Mugda Medical College & Hospital, Dhaka, Bangladesh. Medical records of women who underwent surgical management for endometriosis-related infertility, from January 2021 and December 2024 were reviewed. A total of 104 patients who fulfilled the eligibility criteria were included in the study by purposive sampling. Data were analysed using the Statistical Package for the Social Sciences (SPSS) version 26.0. Result: The laparoscopic group had a shorter operative time (92.4 vs 108.7 minutes), lower intraoperative blood loss (104.6 vs 218.9 mL), lower postoperative pain score (3.1 vs 5.8), shorter hospital stay (2.4 vs 5.6 days), earlier return to normal activities (8.7 vs 16.4 days), and fewer overall postoperative complications (7.7% vs 21.2%). Fertility outcomes also favoured laparoscopy, with a higher overall pregnancy rate (57.7% vs 46.2%) and spontaneous conception rate (42.3% vs 26.9%) compared with open surgery. Conclusion: The findings of the present study indicate that laparoscopic surgery yielded more favourable perioperative and postoperative outcomes than open surgery for the management of endometriosis-related infertility. Patients treated laparoscopically had lower intraoperative blood loss, less postoperative pain, shorter hospitalisation, earlier recovery, fewer postoperative complications, and improved reproductive outcomes, including a higher proportion of spontaneous pregnancies.