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Human Reproduction, Vol. 11, No. suppl_3, pp. 67-88, 1996
© 1996 European Society of Human Reproduction and Embryology

Laparoscopic treatment of symptomatic endometriosis

Jean Luc Pouly1, Julie Drolet, Michel Canis, Sassi Boughazine, Gérard Mage, Maurice-Antoine Bruhat and Arnaud Wattiez

Département de Gynécologie Obstétrique et Médecine de la Reproduction, Polyclinique de I'Hotel Dieu 5 Boulevard Charles de Gaulle, Centre Hospitalier et Universitaire, BP 69 63003 Clermont Ferrand, France

Correspondence: 1To whom correspondence should be addressed

From their experience and from data in the literature, the authors try to define the respective place of the different treatments for endometriosis, especially those of operative laparoscopy. In cases of endometriosis-associated infertility, operative laparoscopy is the first line treatment and assisted reproductive technology (ART) the second one. Gonadotrophin-releasing hormone (GnRH) analogues are only useful in cases of extensive endometriosis to render surgery easier, and for ART. The average pregnancy rate following laparoscopic treatment is ~50% (range 34–80%). It is poorly related to the type of endometriosis except in cases of large adhesions and tubal involvement. However, duration of infertility, age and sperm quality have a direct influence on it. Therefore the authors propose a scheme for the management of endometriosis-associated infertility. In cases of pain, laparoscopic surgery can also be used; however, drugs have a more important role in these cases, to avoid recurrent surgery.

Key words: assisted reproductive technologies/endometriosis/GnRH/laparoscopy


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