Life table analysis of pregnancy rates in women with moderate or severe endometriosis comparing danazol therapy after carbon dioxide laser laparoscopy plus electrocoagulation or laparotomy plus electrocoagulation versus danazol therapy only.
OBJECTIVE
To assess the effectiveness, in terms of pregnancy rates, of isotopic 13CO2 laser laparoscopy versus traditional laparoscopy or laparotomy in the treatment of infertile women with moderate or severe endometriosis.


METHODS
Prospective 5-year study.


METHODS
Medical school-affiliated hospital.


METHODS
Three hundred nine infertile women with moderate to severe endometriosis.


METHODS
The patients were treated with one of four options: operative laparoscopy with the 13carbon dioxide (13CO2) laser vaporization and/or resection, operative laparoscopy with simple electrocoagulation and sharp dissection, laparotomy with electrocoagulation and sharp dissection, and medical treatment with danazol. Estimated cumulative pregnancy rates using life table analyses were indicators of treatment of success and compared among treatments. A subgroup of 192 women considered to have endometriosis as the only infertility factor was also evaluated.


RESULTS
Pregnancy rates in the laparoscopy group were equal to or higher than those of the laparotomy group, for both the entire population and the endometriosis-only subset. When the CO2 laser was used as an adjuvant option, the rates were better, especially in patients with advanced disease and with endometriosis as the only infertility factor.


CONCLUSIONS
In women with endometriosis as the only infertility factor, laparoscopic surgery with the 13CO2 laser was more effective than nonlaser treatment.
Soong
Y K
YK
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taipei, Taiwan, Republic of China.
Chang
F H
FH
Chou
H H
HH
Chang
M Y
MY
Lee
C L
CL
Lai
Y M
YM
Chang
S Y
SY
D000328:Adult; D003131:Combined Modality Therapy; D003613:Danazol / Q000627:therapeutic use*; D004564:Electrocoagulation; D004715:Endometriosis / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D004965:Estrogen Antagonists / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007247:Infertility, Female / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D010535:Laparoscopy; D007813:Laparotomy; D053685:Laser Therapy / Q000295:instrumentation; D015993:Life Tables; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D016896:Treatment Outcome
D004965:Estrogen Antagonists; D003613:Danazol