Treatment of endometriosis-associated infertility with CO2 laser laparoscopy: the use of one- and two-parameter...

Laparoscopic vaporization with the carbon dioxide laser has become a popular treatment modality for endometriosis-associated infertility, yet little data exist regarding the efficacy of such an approach. The authors have applied sophisticated modeling techniques to pregnancy rates in 129 endometriosis patients following laser laparoscopy. Patients were identified for stage of disease, danazol usage before and after surgery, and identifiable infertility factors. Fertility rates were analyzed with monthly fecundity rates and a two-parameter exponential model. Results indicate monthly fecundity rates comparable to other forms of therapy for stage I and stage II endometriosis, but substantially higher than more traditional modalities for stage III disease. The two-parameter model revealed "cure" rates comparable or lower than with major conservative surgery or danazol therapy, but a "monthly" probability of pregnancy" substantially higher than with other treatments. These results indicate that, in experienced hands, laser laparoscopic vaporization of endometriosis is as efficacious as other published forms of therapy, including use in moderate and severe disease. In addition, these results suggest an immediate, transient effect upon the patient with endometriosis-associated infertility.