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Use of laparoscopic cytoreductive surgery to treat infertile women with localized adenomyosis.

Wang CJ, Yuen LT, Chang SD, Lee CL, Soong YK

Department of Obstetrics and Gynecology, Division of Gynecologic Endoscopy, Chang Gung Memorial Hospital, Kwei-Shan Tao-Yuan, Taiwan.

OBJECTIVE: We report on two infertile women with localized adenomyosis who had successful pregnancies after treatment with laparoscopic cytoreductive surgery. DESIGN: Case report. SETTING: Tertiary care university hospital. PATIENT(S): Two infertile women with localized adenomyosis. INTERVENTION(S): Laparoscopic excision of adenomyotic lesion with/without subsequent hypoestrogenic agent was performed. MAIN OUTCOME MEASURE(S): Pregnancy. RESULT(S): Hypoestrogenic agent with danazol was administered 3 months immediately after surgery in one woman. Both women conceived spontaneously at 30 and 21 months after surgery, respectively. The pregnancies were uneventful, and healthy infants were delivered via cesarean section at term. CONCLUSION(S): Laparoscopic cytoreductive surgery can be an alternative treatment to the use of hypoestrogenic agents or hysterectomy in women with localized adenomyosis, especially for those who want to maintain their fertility and achieve successful pregnancies. Patients may wait up to 21 months after surgery until a pregnancy occurs.

Published 2 August 2006 in Fertil Steril, 86(2): 462.e5-8.
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