Combined laparoscopic surgery and pentoxifylline therapy for treatment of endometriosis-associated infertility: a preliminary trial.
BACKGROUND
Surgical treatment has modest efficacy for the treatment of infertility associated with early-stage endometriosis. Immunomodulation with pentoxifylline is considered as a new strategy potentially useful in treating endometriosis. Thus, this study investigated the usefulness of combined laparoscopic surgery and pentoxifylline therapy in the treatment of infertility associated with minimal to mild endometriosis.


METHODS
A prospective, randomized, controlled blind trial was conducted. Patients entered the study immediately after laparoscopic surgery and were randomly assigned to the treatment with either oral pentoxifylline (800 mg/day) (pentoxifylline group, n = 51) or an oral placebo (placebo group, n = 53). Patients were then observed for pregnancy for 6 months.


RESULTS
Among 98 patients finally considered in the evaluation of the results, the 6 month overall pregnancy rates were 28 and 14% in the pentoxifylline and placebo groups, respectively. Thus, an absolute difference of 14% (95% CI -2 to 30) (Chi-squared test, P = 0.1) in the cumulative probability of pregnancy in 6 months after laparoscopic surgery in patients receiving pentoxifylline versus placebo post-operatively was observed.


CONCLUSIONS
Our findings provide preliminary clinical evidence to suggest the new experimental treatment approaches, toward endometriosis, that are based on immunomodulation deserve further attention. Well-designed multicenter trials are warranted to confirm or refute our results.
Creus
Montserrat
M
Institut Clinic of Obstetrics, Gynaecology and Neonatology, Faculty of Medicine-University of Barcelona, Barcelona, Spain.
Fábregues
Francisco
F
Carmona
Francisco
F
del Pino
Marta
M
Manau
Dolors
D
Balasch
Juan
J
D000328:Adult; D003131:Combined Modality Therapy; D004715:Endometriosis / Q000150:complications / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D007247:Infertility, Female / Q000188:drug therapy / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D010535:Laparoscopy; D010431:Pentoxifylline / Q000627:therapeutic use*; D011247:Pregnancy; D018873:Pregnancy Rate
D007155:Immunologic Factors; D010431:Pentoxifylline