Family Medicine (East Africa); General Surgery (East Africa); Obstetrics and Gynaecology (East Africa)
Introduction and importance: Endometriosis is a common cause of infertility in women. In this case report we explain successful conception in deep-infiltrating ovarian endometriosis following robot-assisted surgery and androgenic agonist treatment.
Case presentation: A 38-year-old current Para 2, Living 2 presented 8 years ago with chronic lower abdominal pain, dysmenorrhea, and delayed conception. Advance endometriosis was highly suspected from the history and examination. Robot-assisted laparoscopic partial cystectomy was performed for the deep-infiltrating ovarian endometriosis. She was then discharged with postoperative androgenic agonists and with timed intercourse, she got pregnant within 9 months.
Clinical discussion: Advanced endometriosis (Stage III or IV disease) is associated with distorted pelvic anatomy and adhesions. These changes can impair oocyte release or pick-up, alter sperm motility, cause disordered myometrial contractions, and impair fertilization and embryo transport. Successful rate of conception in advanced endometriosis is <20 >%, with minimal chances of successful conception, however, our patient conceived.
Conclusion: Endometriosis should be considered in evaluation of reproductive woman with chronic lower abdominal pain, history of infertility and dysmenorrhea. Prompt management is crucial, and in a setting of advanced technology, robotic laparoscopic surgery is the best to diagnosis and treat advanced endometriosis.
International Journal of Surgery Case Reports
Ismail, A. Z.,
(2022). Pregnancy following robot-assisted laparoscopic bilateral endometriotic cystectomy rare case report of endometriosis stage IV. International Journal of Surgery Case Reports, 98(107508), 1-4.
Available at: https://ecommons.aku.edu/eastafrica_fhs_mc_fam_med/49
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