Mild and moderate endometriosis. Comparison of treatment modalities for infertile couples.
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In infertile couples with mild to moderate endometriosis, laparoscopic laser treatment and conservative surgery yielded significantly higher pregnancy rates than expectant management, medical treatment, or laparoscopic cautery.
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Abstract
A series of 1,268 consecutive patients with stage I and II endometriosis (American Fertility Society classification) were treated for the disease. In 675, no other factors contributed to their infertility. Among these patients, with no problems other than mild endometriosis, 57% (16/28) became pregnant when treated expectantly, 54% (51/95) after being treated medically, 47% (9/19) after laparoscopic cautery treatment, 81% (147/181) after laparoscopic laser treatment and 84% (97/116) after conservative surgery (laparotomy). Statistical analysis of the pregnancy rates revealed no difference between expectant, medical and laparoscopic cautery treatment. No difference was noted between laparotomy and laser laparoscopy; however, there was a statistically significant difference between these treatments and expectant, medical and cautery treatment. Similar results were seen with stage II endometriosis in couples with no contributing factors other than endometriosis: 39% of patients (23/59) became pregnant after medical treatment, 70% (80/115) after laser laparoscopy and 74% (46/62) after undergoing major conservative treatment (laparotomy). A statistically significant difference between medical treatment and laparotomy as well as laser laparoscopy was noted. However, no such difference existed between laparotomy and laser laparoscopy. Therefore, it appears that in experienced hands the use of laser laparoscopy in stage I and II endometriosis is as successful as major surgery and statistically significantly better than expectant, medical and laparoscopic cautery treatment.
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Cited by (38)
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- Fertility sparing endometriosis surgery: A review 2021
- Résultats de la fertiloscopie opératoire. À propos de 67 cas 2012
- Surgical Therapies: Peritoneal Endometriosis Surgery 2011
- The effectiveness of reproductive surgery in the treatment of female infertility: facts, views and vision. 2010
- Tratamiento de la endometriosis I y II. Revisión de la literatura 2008
- TRATAMIENTO DE LA ENDOMETRIOSIS I Y II: REVISIÓN DE LA LITERATURA A review of the literature concerning treating endometriosis I and II 2008
- The patient with endometriosis: achieving pregnancy 2008
- Reproductive Surgery for Endometriosis-Associated Infertility 2008
- Fertilité après chirurgie cœlioscopique de l'endométriose pelvienne chez des patientes en échec de grossesse 2007
- Detection of peritoneal endometriotic lesions by autofluorescence laparoscopy 2006
- The treatment of mild endometriosis with laser laparoscopy: a two-step treatment analysis of patients whose primary therapy was successful. 2006
- No difference in cycle pregnancy rate and in cumulative live-birth rate between women with surgically treated minimal to mild endometriosis and women with unexplained infertility after controlled ovarian hyperstimulation and intrauterine insemination 2006
- Reproductive outcome after laparoscopic treatment of minimal and mild endometriosis using Helica Thermal Coagulator 2005
- Detection of Nonpigmented Endometriotic Lesions with 5-Aminolevulinic Acid-Induced Fluorescence 2004
- Medikamentöse und konservative Therapie 2004
- Rezidivierende Endometriose?ein Kofaktor der vorzeitigen Menopause? 2003
- Implantation Defects in Infertile Women with Endometriosis 2002
- The Molecular Basis for Implantation Failure in Endometriosis 2002
- The success of laser laparoscopy in the treatment of endometriosis: a two-step analysis. 2001
- Deeply Infiltrating Endometriosis: Implications, Diagnosis, and Management 2001
- Minimal/mild endometriosis and infertility 2000
- Endometriosis and infertility: an integrated approach 1999
- Individualized therapy of sterility caused by endometriosis 1999
- Chapter 9 Surgical Treatment of Endometriosis-associated Infertility 1999
- Ablation of lesions or no treatment in minimalmild endometriosis in infertile women: a randomized trial 1999
- Effects of Endometriomas on Ooccyte Quality, Embryo Quality, and Pregnancy Rates in In Vitro Fertilization Cycles: A Prospective, Case-Controlled Study 1998
- The evidence for the management of endometriosis 1998
- Modern Approach to Endometriosis 1997
- Efficacy of isotopic 13CO2 laser laparoscopic evaporation in the treatment of infertile patients with minimal and mild endometriosis: A life table cumulative pregnancy rates study 1997
- Laparoscopic Surgery in Infertile Women with Minimal or Mild Endometriosis 1997
- LAPAROSCOPIC SURGERY IN INFERTILE WOMEN WITH MINIMAL OR MILD ENDOMETRIOSIS 1997
- Laparoscopic treatment of symptomatic endometriosis 1996
- Operative laparoscopy: surgical modalities 1995
- Treatment of Infertility Associated With Endometriosis 1995
- Surgical treatment of endometriosis-associated infertility: Meta-analysis compared with survival analysis 1994
- KTP/532 laser laparoscopy in the treatment of endometriosis-associated infertility 1992
- KTP/532 laser laparoscopy in the treatment of endometriosis-associated infertility. 1992
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