KTP/532 laser laparoscopy in the treatment of endometriosis-associated infertility

Alexander M. Dlugi, Walid A. Saleh, Gordon Jacobsen
In: Fertility and Sterility · 1992 · vol. 57(6) , pp. 1186–1193 · doi:10.1016/s0015-0282(16)55071-7 · W4297086664
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This study investigated the use of KTP/532 laser laparoscopy for treating infertility associated with endometriosis.

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Abstract

ObjectiveTo determine the clinical effectiveness of the KTP/532 laser in treating endometriosis-associated infertility and to analyze the impact of additional infertility factors on outcome.DesignProspective cohort analysis of 74 consecutive patients followed up to 24 months after surgery.SettingTertiary institutional infertility clinic.Main outcome measuresCumulative pregnancy rates (PRs), monthly fecundity rates, monthly probability of pregnancy, crude PRs, and cure rates.ResultsThirty-eight percent (28) of patients conceived with a mean +/- SE time to conception of 7.2 +/- 0.8 months. The cure rates were 74% for the total patient sample, 51% for stage I, 69% for stage II, and 64% for stage III disease. Patients who had a cervical factor (P = 0.05), who underwent intrauterine insemination (P = 0.03), who received human menopausal gonadotropin (P = 0.03), or who had additional infertility factors (P = 0.02) had significantly lower crude PRs. The presence of additional infertility factors (P less than 0.02) and intrafimbrial adhesions (P less than 0.01) had a significant impact on cure rates. In the absence of additional factors, 60% (12) of patients with stage I and II conceived. When additional factors were excluded, the overall cure rate was 80%.ConclusionThe results indicate that the KTP/532 laser is an effective tool for the treatment of endometriosis-related infertility. The high prevalence of subtle adhesions may lend further impetus to operative laparoscopy for stage I and II disease. Additional infertility factors may adversely affect outcome.

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endometriosisinfertility

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