Management of Infertility Patients with Moderate to Extensive Pelvic Endometriosis by Intra-Abdominal Carbon Dioxide Laser

Abstract

ABSTRACT

Pelvic endometriosis is a common cause of infertility, being implicated in as many as 30% of women who are unable to conceive. When the disease is more severe than Stage I (American Fertility Society Classification for mild endometriosis), it is generally agreed that the best treatment is surgical rather than medical. Conservative surgery has achieved satisfactory pregnancy rates; however, conventional surgical techniques have limitations in patients with severe adhesions or with endometriosis in areas of poor accessibility.

The intra-abdominal use of CO₂ laser can offer precision vaporization, bloodless field, and accessibility to poorly visible areas. The CO₂ laser was used to treat 71 patients with infertility classified as Stage II, III or IV pelvic endometriosis by the American Fertility Society.

Forty-two of the 71 patients (59.2%) attempting pregnancy have conceived at the time of this report. The breakdown for these pregnancies are 63.3% for those with Stage II, 52.9% for those with Stage III, and 40.0% for those with Stage IV.

The observed pregnancy success rate is promising with the use of this new modality of surgical management for this common condition affecting infertile women.