Abstract:  Objective：To analyze retrospectively the multiple factors related to pregnancy before and after the laparoscopic surgery combined with hysteroscopy in those patients with pelvic endometriosis complicated with infertility. It is helpful for clinical treatment of this kind of diseases to explore those main factors related to the postoperative pregnancy. Methods：Clinical data of 247 patients with pelvic endometriosis complicated with infertility, and treated with hysteroscopy combined with laparoscopy, were collected. χ2 test, t test, rank sum test and multi factor Logistic regression were used for analysis. Results：After the operation, 157 cases tried to conduct natural pregnancy, and 90 cases were directly enrolled in the IVF treatment cycle. Finally, 105 cases were not pregnant, and 142 cases had successful pregnancy. There were significant differences in the infertility years, the endometriosis stages (the r-AFS stage), and the fertility index (the EFI score) between women with successful pregnancies and those women without pregnancy after the operation (P＜0.05). However, there were no significant differences in the type of infertility, the incidence of endometrial polyp and the bilateral lesions of ovaries (P＞0.05). The rate of spontaneous pregnancy and IVF-assisted pregnancy was decreased gradually with the postoperative time (P＜0.05). The r-AFS stage and the EFI score were closely related to postoperative pregnancy (P＜0.05), the high EFI score was the protective factor while the high r-AFS stage was the risk factor of postoperative pregnancy. Conclusions：The r-AFS stage, the EFI score and the infertility years are important factors affecting postoperative pregnancy in those patients with endometriosis after laparoscopic treatment. The rate of postoperative pregnancy can be significantly improved by the active direction of natural pregnancy and active IVF treatment according to the evaluation index of disease, as earlier as possible.

Key words: Endometriosis, Infertility, Laparoscopy combined with hysteroscopy, Related factors