Medical treatment of mild endometriosis associated with infertility

Abstract

Infertility in women with mild endometriosis may be treated in many ways, some of which are not directly aimed at eliminating endometriosis (IVF-ET [l], GIFT [2], controlled superovulation [3], expectant management [4]). On the other hand, the treatment of mild endometriosis in infertile women is based on the proposition that the disease is the cause of infertility and that the lesions must be reduced or eliminated to increase the chances of pregnancy. This is reasonable in severe forms in which the usefulness of conservative surgery has been proven [5]. At revised American Fertility Society classification (R-AFS) [6] stages I and II (minimal and mild endometriosis), a laparotomy is out of proportion. Some authors try to eliminate limited lesions by electrocoagulation [7] or laser laparoscopy at the time of diagnosis [8], whereas others, in the absence of adnexal adhesions, prefer to induce regression of the active lesions by pharmacologic treatments [9]. In this paper we review the rationale and results of drugs in current use; treatments of historic