The value of two-step operative laparoscopy with interval pituitary suppression in the treatment of infertility caused by severe endometriosis

Elizabeth Ball, Hugh Byrne, Hugh J. Byrne, Colin Davis, Colin J. Davis
Current opinion in obstetrics & gynecology · 2007 · vol. 19(4) , pp. 303–307 · doi:10.1097/gco.0b013e328216f642 · PMID:17625409 · W2010230252
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Two-step operative laparoscopy with interval pituitary suppression effectively reduces endometriosis extent and facilitates surgery for severe cases, potentially improving outcomes for infertile patients not opting for IVF.

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Abstract

PURPOSE OF REVIEW: To appraise a new approach to laparoscopic surgery for infertility caused by advanced endometriosis. RECENT FINDINGS: Endometriosis is a common systemic and local disease with altered peritoneal function, which requires both systemic and local treatment. Medication alone cannot improve infertility, and laparoscopic treatment, particularly in severe endometriosis, has a high recurrence rate and is often limited by technical difficulties. Novel treatment strategies have therefore to be sought, especially in women who do not want in-vitro fertilization as a first option, either because they suffer from pain in addition to infertility or want to enhance their fertility over many cycles. SUMMARY: Two-step operative laparoscopy with interval pituitary suppression by means of gonadotrophin-releasing hormone analogues reduces the extent of endometriosis, as classified by the American Fertility Association, and appears to be a promising method of achieving optimal cytoreduction and facilitating complicated surgery in severe endometriosis, while protecting the ovary from unnecessary trauma. A large-scale well-designed study is needed to confirm that this treatment leads to improved pregnancy rates.

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Condition tags

endometriosisinfertility

MeSH descriptors

Endometriosis Gonadotropin-Releasing Hormone Infertility, Female Infertility, Female Infertility, Female Infertility, Female Laparoscopy Combined Modality Therapy Endometriosis Endometriosis Endometriosis Female Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone Humans Laparoscopy Treatment Outcome

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (59)

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