| Objective: Endometriosis refers to the growth of endometrial tissue outside the uterus occurs and other parts of the body, called endometriosis. Histologically benign performance, but in the clinical behavior of malignant behavior. Its pathogenesis is complex, extensive lesions, varied shapes, very invasive and recurrent, so far not yet fully explained its mechanism, the patient usually presents with chronic pelvic pain, infertility, sexual intercourse discomfort, pelvic mass, menstrual abnormalities, which where infertility is a serious impact on family stability and normal life. Buyalos first proposed the concept of endometriosis with infertility in 2000. It changes the pelvic anatomy affect pick up eggs and fertilized transport; destroy ovarian tissue, resulting in reduced ovarian reserve, decreased egg quality, ovulation disorders; changes in the endometrial tissue morphology and secrete immune molecules, reduce endometrial receptivity, disrupt the normal fertilization process and abnormal immune inflammatory response; through normal pregnancy affect many aspects of the role of these patients. This topic through retrospective analysis of clinical data and study a combination of literature, from the pathophysiological basis of endometriosis, staging, patient age, lesion side do not affect surgical technique and surgeon, surgery and drugs combined gynecological various factors affect the disease as well as endometriosis on assisted reproduction and other comparative analysis, research, learning about the effects of various treatments of endometriosis disease in itself, and surgery and drugs on pregnancy functions.Methods: It is case study analysis. Select from June 2008 to June 2013 due to lower cases of endometriosis with infertility laparoscopic conservative surgery, track pregnancy after 1 year, randomly selected 50 cases in which the pregnancy was not successful as the study group, 50 cases of successful pregnancy as a control group, were studied. Statistical analysis of the basic information and operations, including the basis of hormone levels, age, surgery to stop bleeding, surgical staging, pathological side do not, surgery and the influence of drugs, relapse, duration of infertility and pregnancy after the time limit, count data line X2 test univariate comparison between groups of rows, while learning the literature on the impact of various factors in the pathophysiology of endometriosis and endometriosis on assisted reproduction, etc., through the postoperative patient review and telephone follow-up after pregnancy, and to analyze the above factors on the postoperative pregnancy rate.Results: Study group, the mean age 36.1 ± 2.4 years; the control group, the mean age 27.1 ± 3.1 years; the average age of the study group than in the control group large, the average age difference between the two groups was significant, statistically significant(P <0.05). In study group E2 mean 60.7 ± 2.48pg/ml, significantly higher than the 46.1 ± 2.29pg/ml, significantly different statistically significant(P <0.05). Study groups FSH, LH mean were 6.61 ± 2.99mIU/ml, 5.34 ± 3.29mIU/ml, and the control group 6.39 ± 3.18mIU/ml, 5.48 ± 3.37mIU/ml the difference was not significant, was not statistically significant(P> 0.05). Study Group coagulation method 34 cases(68%), hemostasis method in 12 cases, 24%; 18 cases in the control group coagulation method, 36%, suture 30 cases(60%); Study Group coagulation the number of cases than the control group, the difference was significant, statistically significant(P <0.05). Unilateral and bilateral research group the number of cases was 16(32%), 30(60%); the control group alone, the number of cases on both sides were: 37(74%), 11(22%), the difference there was statistically significant(P <0.05), unilateral or bilateral lesions and endometriosis after pregnancy rate significantly correlated. In study group I-II period is 15 cases(30%), III-IV period is 35 cases(70%).in the control group I-II of 39 cases(78%), III-IV period 11 patients(22%), indicating that III-IV period after pregnancy compared with I-II was significantly reduced, compared the two groups was significantly(P <0.05). All patients were divided according to whether postoperative adjuvant A, group B, A group was combined with GnRH-a(Diphereline); group B was not used any drugs; A group after three months of treatment, discontinuation After trying to conceive, Group B after January began trying to conceive; surgery patients divided into stages according to Light(I-II period), heavy(III-IV stage) degrees; postoperative follow-up of 1 year in patients with mild Study group A, group B the number of cases was 7(46.7%), 8(53.3%); the control group A, group B the number of cases was 20(51.3%), 19(48.7%), the difference was not significant, No statistically significant(P> 0.05), explained after GnRHa therapy to improve the I-II patients with infertility pregnancy rate of EMT little help; in severe patients, the study group A, group B the number of cases was 11(31.4 %), 24(68.6%); the control group A, group B the number of cases was 8(72.7%), 3(27.3%), a significant difference was statistically significant(P <0.05), explained after Gn RHa treatment to improve the efficacy of stage III-IV pregnancy EMT infertility patients significantly. All patients after six months and one year to the week after the menstrual clean expert B ultrasound, exploration and attachment area of cyst diameter ≥2cm, accompanied by dysmenorrhea, pelvic pain and other symptoms of sexual blow regarded as recurrence, the recurrence rate between the two groups; study group after 1 year 23 cases of recurrence(46%), including 11 cases of patients undergoing late stage(III-IV stage), relapse within six months after all; the control group, 11 cases of recurrence within 1 year(22 %); compared the two groups, the study group was significantly higher relapse a few cases, the system has considered significant difference(P <0.05). All patients were divided into group A duration of infertility: ≤ 2 years; group B: 2- 5 years; Group C: ≥ 5 years; the study group, 10 cases in group A(20%), 26 cases of group B( 52%), 14 cases of group C(28%); control group, 34 cases in group A(68%), group B 13 patients(26%), group C 3 patients(6%); two groups, the study group does not gestational age was higher than the proportion of elderly people in the control group, the difference was statistically significant(P <0.05); but more than 5 years duration of infertility, however, reduced the proportion, considering the number of such patients is due less. Patients in the control group within six months of pregnancy, 29 patients(58%), six to twelve of pregnancy in 21 cases(42%), significant difference was statistically significant(P <0.05).Conclusion: 1. The present study research group age, duration of infertility and the ratio of E2 values were higher than those in the control group, suggested that age and duration of infertility is the impact of endometriosis patients with ovarian function and pregnancy outcome of important factor.2. The study results suggest that the pregnancy rate of endometriosis associated infertility after operation and the level of the r-AFS staging was negative correlation, namely to the later stages of pregnancy rate is low. So patients with endometriosis associated infertility should follow the principle of early detection and early treatment.3. Laparoscopic operation has become the preferred treatment and diagnosis treatment of EMT complicated with infertility. Postoperative best pregnant time should be less than 6 months, but the pregnancy rate after electric coagulation hemostasis with suture hemostasis spell is low, the operation should pay attention to the operation and operational details, and enhance awareness of the protection of the ovarian. 4. For stage I and II endometriosis associated infertility patients, therapeutic effect of laparoscopic surgery combined with GnRHa therapy and simple laparoscopic surgery were similar. For III, IV, GnRHa combined treatment after operation, the pregnancy rate was significantly higher than that of operation.
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