{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T19:12:28Z","timestamp":1785611548682,"version":"3.56.0"},"reference-count":50,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2020,2,13]],"date-time":"2020-02-13T00:00:00Z","timestamp":1581552000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Aim: This study examined the fertility performance of women after combined hysterolaparoscopic surgical management of endometriosis. Design: This study is a hospital-based retrospective review. Materials and Methods: Data collected from the records of all patients presented with endometriosis-related infertility using a checklist designed for the purpose. Result: A total of 81.3% (370\/455) of women who have had the desire to have children became pregnant during the study period after the surgery. Of those who became pregnant, all three-hundred-forty-seven patients were followed to the end of their pregnancies. A successful live birth occurred in 94.2% (327\/347) of individuals, and pregnancy loss occurred in 5.8% (20\/347). The mean patient age was 34.1 \u00b1 4.1 years, and the average duration of infertility was 3.4 \u00b1 3.3 years. Pregnancy occurred spontaneously in 39.5% (146\/370) of patients, after artificial insemination (AIH) in 3.8% (14\/370) of women, and after in vitro fertilization-embryo transfer (IVF-ET) in 56.8% (210\/370) of cases. Patients aged \u2264 35 years had a higher chance of conception post-surgery\u201484% versus 77%, respectively (p = 0.039). Based on the modes of pregnancy, the timely introduction of an assisted reproductive technique (ART) demonstrated a significant effect on fertility performance postsurgery. Comparatively, this effect was 91.3% vs. 74.1% among the \u226435- and &gt;35-year-old age groups, respectively. There was no significant difference in reproductive performance based on stages of endometriosis, nor in the other parameters evaluated. Conclusion: Our data are consistent with previous clinical studies regarding the management options of endometriosis-related infertility. Overall, the combined hysterolaparoscopy treatment is a very effective and reliable procedure, and is even more effective when combined with ART. It enhances women\u2019s wellbeing and quality of life, and significantly improves reproductive performance.<\/jats:p>","DOI":"10.3390\/jcm9020507","type":"journal-article","created":{"date-parts":[[2020,2,25]],"date-time":"2020-02-25T08:12:22Z","timestamp":1582618342000},"page":"507","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["The Surgical Benefit of Hysterolaparoscopy in Endometriosis-Related Infertility: A Single Centre Retrospective Study with a Minimum 2-Year Follow-Up"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1834-9123","authenticated-orcid":false,"given":"Atombosoba Adokiye","family":"Ekine","sequence":"first","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology, Robert K\u00e1roly Private Hospital, 1135 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Istv\u00e1n","family":"F\u00fcl\u00f6p","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology, Robert K\u00e1roly Private Hospital, 1135 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Istv\u00e1n","family":"Tekse","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology, Robert K\u00e1roly Private Hospital, 1135 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1rp\u00e1d","family":"R\u00facz","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology, Robert K\u00e1roly Private Hospital, 1135 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Jeges","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, University of P\u00e9cs, 48-as t\u00e9r 1, 7622 P\u00e9cs, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1gnes","family":"Kopp\u00e1n","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, University of P\u00e9cs, 48-as t\u00e9r 1, 7622 P\u00e9cs, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikl\u00f3s","family":"Kopp\u00e1n","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology, University of P\u00e9cs, 48-as t\u00e9r 1, 7622 P\u00e9cs, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,2,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1016\/S0015-0282(16)55911-1","article-title":"A quantitative overview of controlled trials in endometriosis-associated infertility","volume":"59","author":"Hughes","year":"1993","journal-title":"Fertil. Steril."},{"key":"ref_2","first-page":"109","article-title":"Surgery for endometriosis-associated infertility: Do we exaggerate the magnitude of effect?","volume":"7","author":"Rizk","year":"2015","journal-title":"Facts Views Vis. ObGyn"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1556\/oh.2010.28904","article-title":"Az endometriosis korszer\u0171 laparoszk\u00f3pos seb\u00e9szi kezel\u00e9se","volume":"151","author":"Berkes","year":"2010","journal-title":"Orv. Hetil."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.tjog.2013.02.004","article-title":"Laparoscopic surgery for subfertility related to endometriosis: A meta-analysis","volume":"53","author":"Jin","year":"2014","journal-title":"Taiwan. J. Obstet. Gynecol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1007\/s13669-017-0187-1","article-title":"Endometriosis: Epidemiology, Diagnosis and Clinical Management","volume":"6","author":"Parasar","year":"2017","journal-title":"Curr. Obstet. Gynecol. Rep."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1055\/s-2003-41330","article-title":"Endometriosis and subfertility: Is the relationship resolved?","volume":"21","author":"Debrock","year":"2003","journal-title":"Semin. Reprod. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/j.fertnstert.2011.05.090","article-title":"Impact of endometriosis on quality of life and work productivity: A multicentre study across ten countries","volume":"96","author":"Nnoaham","year":"2011","journal-title":"Fertil. Steril."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/j.fertnstert.2012.08.001","article-title":"Endometriosis: Ancient disease, ancient treatments","volume":"98","author":"Nezhat","year":"2012","journal-title":"Fertil. Steril."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"595","DOI":"10.2741\/1821","article-title":"Endometriosis: Harmful survival of an ectopic tissue","volume":"11","author":"Garai","year":"2006","journal-title":"Front. Biosci."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1097\/GRF.0b013e3182353e06","article-title":"Managing endometriosis-associated infertility","volume":"54","author":"Senapati","year":"2011","journal-title":"Clin. Obstet. Gynecol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1016\/S0002-9378(15)30003-X","article-title":"Peritoneal endometriosis due to the menstrual dissemination of endometrial tissue into the peritoneal cavity","volume":"14","author":"Sampson","year":"1927","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.jmig.2009.02.007","article-title":"Laparoscopic management of endometriosis: Comprehensive review of best evidence","volume":"16","author":"Yeung","year":"2009","journal-title":"J. Minim. Invasive Gynecol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1016\/j.ogc.2012.10.002","article-title":"Endometriosis and infertility: A review of the pathogenesis and treatment of endometriosis-associated infertility","volume":"39","author":"Macer","year":"2012","journal-title":"Obstet. Gynecol. Clin."},{"key":"ref_14","first-page":"3112","article-title":"Ovarian steroid regulation of vascular endothelial growth factor in human endometrium: Implication for angiogenesis during the menstrual cycle and in the pathogenesis of endometriosis","volume":"81","author":"Shifren","year":"1996","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/j.fertnstert.2012.06.029","article-title":"Pathogenesis and pathophysiology of endometriosis","volume":"98","author":"Burney","year":"2012","journal-title":"Fertil. Steril."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"3814","DOI":"10.1210\/en.2006-1692","article-title":"Gene expression analysis of endometrium reveals progesterone resistance and candidate susceptibility genes in women with endometriosis","volume":"148","author":"Burney","year":"2007","journal-title":"Endocrinology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1097\/GRF.0b013e3181db7d71","article-title":"Endometriosis and infertility","volume":"53","author":"Holoch","year":"2010","journal-title":"Clin. Obstet. Gynecol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/S0015-0282(97)81915-2","article-title":"Incidence of apoptotic bodies in membrana granulosa of the patients participating in an in vitro fertilization program","volume":"67","author":"Nakahara","year":"1997","journal-title":"Fertil. Steril."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1108","DOI":"10.1016\/S0015-0282(16)57556-6","article-title":"The revised American Fertility Society classification of endometriosis: Reproducibility of scoring","volume":"63","author":"Rock","year":"1995","journal-title":"Fertil. Steril."},{"key":"ref_20","first-page":"2553","article-title":"Interleukin-6 differentially stimulates haptoglobin production by peritoneal and endometriotic cells in vitro: A model for endometrial peritoneal interaction in endometriosis","volume":"2386","author":"Piva","year":"2001","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0015-0282(00)01630-7","article-title":"Immunobiology of endometriosis","volume":"75","author":"Lebovic","year":"2001","journal-title":"Fertil. Steril."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"24","DOI":"10.3389\/fsurg.2014.00024","article-title":"Endometriosis and infertility: How and when to treat?","volume":"1","author":"Fadhlaoui","year":"2014","journal-title":"Front. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Morassutto, C., Monasta, L., Ricci, G., Barbone, F., and Ronfani, L. (2016). Incidence and estimated prevalence of endometriosis and adenomyosis in Northeast Italy: A data linkage study. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0154227"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1159\/000093120","article-title":"Why we need a noninvasive diagnostic test for minimal to mild endometriosis with a high sensitivity","volume":"62","author":"Mihalyi","year":"2006","journal-title":"Gynecol. Obstet. Investig."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1111\/1471-0528.14711","article-title":"Epidemiology of endometriosis: A large population-based database study from a healthcare provider with 2 million members","volume":"125","author":"Eisenberg","year":"2018","journal-title":"BJOG"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2590","DOI":"10.14260\/Jemds\/2017\/560","article-title":"Role of diagnostic laparoscopy and hysteroscopy in infertility","volume":"6","author":"Sreekanth","year":"2017","journal-title":"J. Evol. Med. Dent. Sci."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"44","DOI":"10.17305\/bjbms.2008.2996","article-title":"Should diagnostic hysteroscopy be a routine procedure during diagnostic laparoscopy in infertile women?","volume":"8","author":"Godinjak","year":"2008","journal-title":"Bosn. J. Basic Med. Sci."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Mascarenhas, M.N., Flaxman, S.R., Boerma, T., Vanderpoel, S., and Stevens, G.A. (2012). National, regional, and global trends in infertility prevalence since 1990: A systematic analysis of 277 health surveys. PLoS Med., 9.","DOI":"10.1371\/journal.pmed.1001356"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"881","DOI":"10.2471\/BLT.10.011210","article-title":"Mother or nothing: The agony of infertility","volume":"88","author":"Cui","year":"2010","journal-title":"Bull. World Health Organ."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"101","DOI":"10.3109\/0167482X.2010.481337","article-title":"Investigating quality of life and health-related quality of life in infertility: A systematic review","volume":"31","author":"Chachamovich","year":"2010","journal-title":"J. Psychosom. Obstet. Gynaecol."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Batt, R.E. (2011). A History of Endometriosis, Springer.","DOI":"10.1007\/978-0-85729-585-9"},{"key":"ref_32","first-page":"CD001398","article-title":"Laparoscopic surgery for subfertility associated with endometriosis","volume":"4","author":"Jacobson","year":"2002","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1056\/NEJM199707243370401","article-title":"Laparoscopic surgery in infertile women with minimal or mild endometriosis. Canadian Collaborative Group on Endometriosis","volume":"337","author":"Marcoux","year":"1997","journal-title":"N. Eng. J. Med."},{"key":"ref_34","first-page":"CD010537","article-title":"Assisted reproductive technology: An overview of Cochrane Reviews","volume":"7","author":"Farquhar","year":"2018","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1016\/j.jgyn.2007.02.013","article-title":"Reproductive outcome after laparoscopic treatment of endometriosis in infertile population","volume":"36","author":"Fuchs","year":"2007","journal-title":"J. Gynecol. Obstet. Biol. Reprod."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1016\/S0015-0282(16)47836-2","article-title":"Comparison of diagnostic accuracy of laparoscopy, hysteroscopy, and hysterosalpingography in evaluation of female infertility","volume":"41","author":"Snowden","year":"1984","journal-title":"Fertil. Steril."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2698","DOI":"10.1093\/humrep\/dei135","article-title":"ESHRE guideline for the diagnosis and treatment of endometriosis","volume":"20","author":"Kennedy","year":"2005","journal-title":"Hum. Reprod."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"3130","DOI":"10.1093\/humrep\/dei176","article-title":"Effect of endometriosis on IVF\/ICSI outcome: Stage III\/IV endometriosis worsens cumulative pregnancy and live-born rates","volume":"20","author":"Kuivasaari","year":"2005","journal-title":"Hum. Reprod."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"329","DOI":"10.5604\/12321966.1152089","article-title":"Effectiveness of laparoscopic surgeries in treating infertility related to endometriosis","volume":"22","author":"Ciebiera","year":"2015","journal-title":"Ann. Agric. Environ. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1016\/j.fertnstert.2004.07.971","article-title":"Laparoscopic treatment of pelvic pain associated with minimal and mild endometriosis with use of the Helica Thermal Coagulator","volume":"83","author":"Nardo","year":"2005","journal-title":"Fertil. Steril."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1196\/annals.1434.007","article-title":"Endometriosis and infertility: Epidemiology and evidence-based treatments","volume":"11","author":"Ozkan","year":"2008","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_42","first-page":"QC01","article-title":"Prevalence; characteristics and management of endometriosis amongst infertile women: A one-year retrospective study","volume":"9","author":"Vineet","year":"2015","journal-title":"J. Clin. Diagn. Res."},{"key":"ref_43","first-page":"224","article-title":"Stages of endometriosis: Does it affect in vitro fertilization outcome","volume":"54","author":"Trajkovic","year":"2015","journal-title":"Taiwan. J. Obstet. Gynecol."},{"key":"ref_44","first-page":"235","article-title":"Fertility outcome after operative laparoscopy versus no treatment in infertile women with minimal or mild endometriosis","volume":"5","author":"Moini","year":"2012","journal-title":"Int. J. Fertil. Steril."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"156","DOI":"10.5455\/msm.2014.26.156-157","article-title":"Combined hysterolaparoscopy for the diagnosis of female infertility: A retrospective study of 132 patients in China","volume":"26","author":"Zhang","year":"2014","journal-title":"Mater. Socio Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"429","DOI":"10.3109\/00016348809004254","article-title":"Causes and outcome of infertility in previously unexplained couples","volume":"67","author":"Rantala","year":"1988","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.1016\/S0015-0282(98)00081-8","article-title":"Fecundity of infertile women with minimal or mild endometriosis and women with unexplained infertility","volume":"69","author":"Marcoux","year":"1998","journal-title":"Fertil. Steril."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1007\/s10815-010-9436-1","article-title":"Endometriosis and infertility","volume":"27","author":"Bulletti","year":"2010","journal-title":"J. Assist. Reprod. Genet."},{"key":"ref_49","first-page":"438790","article-title":"The Surgical Treatment of Severe Endometriosis Positively Affects the Chance of Natural or Assisted Pregnancy Postoperatively","volume":"2015","author":"Campbell","year":"2015","journal-title":"Biomed. Res. Int."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"2229","DOI":"10.1080\/03007995.2017.1362377","article-title":"Surgical outcomes of laparoscopic endometriosis surgery: A 6-year experience","volume":"33","author":"Alborzi","year":"2017","journal-title":"Curr. Med. Res. Opin."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/2\/507\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T08:57:20Z","timestamp":1760173040000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/2\/507"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,13]]},"references-count":50,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2020,2]]}},"alternative-id":["jcm9020507"],"URL":"https:\/\/doi.org\/10.3390\/jcm9020507","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2,13]]}}}