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.
OBJECTIVE
To assess the efficacy of 13CO2 laser laparoscopy in treating infertile women with minimal to mild endometriosis according the American Fertility Society classification in terms of pregnancy rates.


METHODS
Prospective study.


METHODS
Medical school-affiliated hospital.


METHODS
One hundred seventy-six women whose infertility was associated with minimal or mild endometriosis diagnosed by laparoscopy.


METHODS
The patients were treated with one of four methods: 49 underwent operative laparoscopy with newly developed 13CO2 laser vaporization and/or resection; 45 were treated by operative laparoscopy with simple monopolar electrocoagulation; 43 who had undergone only diagnostic laparoscopy did not receive any treatment; and 39 received danazol 800 mg/day for 3 months after diagnostic laparoscopy.


RESULTS
Estimated cumulative pregnancy rates using life table analyses were indicators of treatment of success and compared among the treatments. A subgroup of 111 patients considered to have endometriosis as the only major infertility factor were also evaluated and compared among treatment options. Pregnancy rates in the CO2 laser laparoscopy group were significantly higher than in the other three groups and in endometriosis-only subset.


CONCLUSIONS
Advanced laparoscopic surgery with the CO2 laser can be more efficient than other modalities in treating infertile women with minimal to mild endometriosis in terms of pregnancy rates. It appears that in experienced hands, laser laparoscopy has more favorable results than the other treatments.
Chang
F H
FH
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taipei, Taiwan, Republic of China.
Chou
H H
HH
Soong
Y K
YK
Chang
M Y
MY
Lee
C L
CL
Lai
Y M
YM
D000328:Adult; D003613:Danazol / Q000627:therapeutic use; D004564:Electrocoagulation / Q000379:methods; D004715:Endometriosis / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D004965:Estrogen Antagonists / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy / Q000209:etiology / Q000601:surgery*; D020706:Laparoscopes; D053685:Laser Therapy / Q000379:methods*; D015993:Life Tables; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D015203:Reproducibility of Results; D016896:Treatment Outcome
D004965:Estrogen Antagonists; D003613:Danazol