[Occult and minimal forms of endometriosis: therapeutic strategies]

The hidden forms of endometriosis, especially the microscopic or non visible endometriosis, are entities presenting difficult problems for the diagnosis and sometimes the selection of a treatment; non visible endometriosis seems to be more of an interesting theoretical concept as long as its existence and clinical significance will not have been better documented and confirmed. Minimal endometriosis (Stage I of the AFS-1985 classification) is frequent in infertility cases and its incidence is probably underestimated because of atypical aspects better known today. Its relationship with infertility still seems hypothetical, even if new data seem to implicate it to a greater degree. Numerous disorders have been found to explain the harmful effect of endometriosis on sterility. All the usual means of treatment of endometriosis may be selected; however, coelioscopic destruction at the time of the diagnosis seems most appropriate in case of pain or infertility; in the latter group, secondarily, a short medical treatment may be used before resorting to Fertilization in vitro of GIFT, which will be preferred if the patient is older and there is a long history of infertility.