Human Reproduction, Vol. 14, No. 5, 1332-1334,
May 1999
© 1999 European Society of Human Reproduction and Embryology
Ablation of lesions or no treatment in minimal–mild endometriosis in infertile women: a randomized trial
Correspondence: Dr Fabio Parazzini, Istituto di Ricerche Farmacologiche `Mario Negri', via Eritrea, 62–20157 Milano, Italy
In order to analyse the efficacy of resection/ablation of minimal/mild endometriotic lesions for improving fertility, we conducted a randomized clinical trial. Eligible patients were women aged 
36 years who were trying to conceive and had a laparoscopically confirmed diagnosis of minimal/mild endometriosis (stage I or II of the revised American Fertility Society classification) and otherwise unexplained infertility for 
2 years. Eligible women were randomly assigned to resection or ablation of visible endometriosis (54 patients) or diagnostic laparoscopy only (47 patients). After laparoscopy women tried to conceive spontaneously for 1 year (follow-up period). A total of five women withdrew from the study: three for personal reasons, and two were lost to follow-up. Considering 51 women in the resection/ablation and 45 in the no-treatment group who ended the follow-up period, 12 (24%) in the resection/ablation group and 13 (29%) in the no treatment group conceived; the difference was not significant. Two spontaneous abortions were observed in the resection/ablation group and three in the no-treatment one. Thus the 1 year birth rate was 10 out of 51 women (19.6%) in the resection/ablation group and 10 out of 45 women (22.2%) in the no-treatment group. In conclusion, the results of this study do not support the hypothesis that ablation of endometriotic lesions markedly improves fertility rates.
Key words: clinical trial/endometriosis/infertility/laparoscopy
* Istituto di Ricerche Farmacologiche `Mario Negri' and Prima Clinica Ostetrico Ginecologica, Universita di Milano (co-ordination and data analysis: Fabio Parazzini, Elisabetta Di Cintio, Liliane Chatenoud, Simona Moroni). Ospedale Civile di Benevento (Italo Ardovino, Elisario Struzziero); Firenze, Clinica Ostetrico Ginecologica (Gianluca Bracco 2nd Clinic, Alessandra Pellegrini 1st Clinic); Milano Ospedale `M. Melloni' (Carlo Bertulessi); Milano, Clinica Ostetrico Gineco-logica `Mangiagalli' (Mauro Busacca, Luciano Gruft (2nd Clinic), Guido Ragni (1st Clinic)); Torino, Clinica Ostetrico Ginecologica `Mauriziano' (Marco Massobrio, Cristina Ansaldi); Torino, Ospedale `S. Luigi' (Gian Franco Trossarelli, Enrico Eusebio); Trieste, Clinica Ostetrico Ginecologica (Luigi Troiano, Giuseppe Ricci).
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