Clinical significance of focal pelvic endometriosis

Clinical findings in a group of infertile patients with endometriosis were reviewed to determine if minimal (focal) disease exerted an effect on reproductive outcome. Focal disease, defined as isolated implants less than or equal to 5 mm without pelvic adhesions or anatomic distortion, was found in 69 patients, with 35% manifesting menstrual dysfunction/anovulation. Patients with focal disease were divided into two groups: those treated with danazol (400-800 mg) daily for six months and those not treated. Conception occurred in 71% of the danazol-treated patients and 30% of the untreated ones. These results suggest that focal endometriosis does influence reproductive performance and that infertile patients with focal disease should be treated more aggressively with the available medical regimens, particularly when the infertility is of significant duration or when routine therapy has failed.