Voorburg

Researchers are evaluating whether laparoscopic removal of colorectal endometriosis improves the chances of having a live birth, both naturally and after fertility treatments like in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). This study focuses on women with colorectal endometriosis, a condition where tissue similar to the uterine lining grows outside the uterus, causing pain and fertility problems. The goal is to compare the overall success of surgery versus IVF/ICSI treatment pathways, including patient-reported outcomes, within a Dutch healthcare context. Participants will either undergo laparoscopic surgery to remove colorectal endometriosis or follow a maximum of three IVF/ICSI cycles according to local protocols. Surgery may involve different techniques based on the size and extent of the endometriosis, such as shaving, discoid excision, or segmental bowel resection. The IVF/ICSI treatment may be preceded by three months of hormonal downregulation. The study captures a treatment timeline including up to three IVF/ICSI attempts or surgical intervention. During the study, participants will be closely monitored for live births over a total period of up to 40 months, including follow-up after treatments. Researchers will also assess patient-reported outcome measures to understand quality of life and symptom changes. The primary outcome is the cumulative live birth rate after the study period, which includes live births following spontaneous conception, IVF/ICSI, or surgery.