Ablation of lesions or no treatment in minimalmild endometriosis in infertile women: a randomized trial

F Parazzini, G. I. p. l. S. dell'Endometriosi
Human Reproduction · 1999 · vol. 14(5) , pp. 1332–1334 · doi:10.1093/humrep/14.5.1332 · PMID:10325288 · W2125214294
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This randomized trial found no significant difference in pregnancy rates between infertile women with minimal/mild endometriosis who underwent lesion ablation or diagnostic laparoscopy alone.

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Abstract

In order to analyse the efficacy of resection/ablation of minimal/mild endometriotic lesions for improving fertility, we conducted a randomized clinical trial. Eligible patients were women aged </=36 years who were trying to conceive and had a laparoscopically confirmed diagnosis of minimal/mild endometriosis (stage I or II of the revised American Fertility Society classification) and otherwise unexplained infertility for >/=2 years. Eligible women were randomly assigned to resection or ablation of visible endometriosis (54 patients) or diagnostic laparoscopy only (47 patients). After laparoscopy women tried to conceive spontaneously for 1 year (follow-up period). A total of five women withdrew from the study: three for personal reasons, and two were lost to follow-up. Considering 51 women in the resection/ablation and 45 in the no-treatment group who ended the follow-up period, 12 (24%) in the resection/ablation group and 13 (29%) in the no treatment group conceived; the difference was not significant. Two spontaneous abortions were observed in the resection/ablation group and three in the no-treatment one. Thus the 1 year birth rate was 10 out of 51 women (19.6%) in the resection/ablation group and 10 out of 45 women (22.2%) in the no-treatment group. In conclusion, the results of this study do not support the hypothesis that ablation of endometriotic lesions markedly improves fertility rates.

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Condition tags

mesh:D004715endometriosisinfertility

MeSH descriptors

Endometriosis Infertility, Female Laparoscopy Pregnancy Outcome Pregnancy Rate Adult Endometriosis Female Humans Infertility, Female Pregnancy Prognosis

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Cited by (50)

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