Pregnancy rates following various therapy modes for endometriosis in infertile patients

A total of 215 infertile patients with endometriosis verified at least laparoscopically were treated between 1977 and 1982 by conservative surgery alone (N = 90), or with danazol, 600 mg daily and most often for 6 months, either alone (N = 59) or postoperatively (N = 44), or by laparoscopic electrocautery of endometriotic foci (N = 18). The mean age and duration of infertility were about the same in all groups. The disease was mild in the electrocoagulated group, moderate in the groups treated either exclusively surgically or with danazol, and most severe among the patients who received danazol following surgery. The uncorrected pregnancy rate after conservative surgery was 43% and the mean interval until conception was 11.7 months. After 6 months' danazol treatment the uncorrected pregnancy rate was 56% and the mean interval until conception was significantly (p less than 0.02) shorter, 6.7 months. Conservative surgery followed by danazol treatment for 6 months resulted in fewer pregnancies (pregnancy rate 32%) but the mean interval until conception was about the same (6.9 months) as after danazol therapy alone. After laparoscopic electrocautery the pregnancy rate was only 17%. In view of these results, we recommend that for infertile patients with mild or moderate endometriosis the recommended treatment should be medical, e.g., danazol 600 mg daily for 6 months.