Efficacy of isotopic 13CO₂ laser laparoscopic evaporation in the treatment of infertile patients with minimal and mild endometriosis: A life table cumulative pregnancy rates study

Study Objective. To assess the efficacy of 13CO₂ laser laparoscopy in treating infertile women with minimal to mild endometriosis according the American Fertility Society classification in terms of pregnancy rates. Design. Prospective study. Setting. Medical school-affiliated hospital. Patients. One hundred seventy-six women whose infertility was associated with minimal or mild endometriosis diagnosed by laparoscopy. Interventions. The patients were treated with one of four methods: 49 underwent operative laparoscopy with newly developed 13CO₂ laser vaporization and/or resection; 45 were treated by operative laparoscopy with simple monopolar electrocoagulation; 43 who had undergone only diagnostic laparoscopy did not receive any treatment; and 39 received danazol 800 mg/day for 3 months after diagnostic laparoscopy. Measurements and Main Results. Estimated cumulative pregnancy rates using life table analyses were indicators of treatment of success and compared among the treatments. A subgroup of 111 patients considered to have endometriosis as the only major infertility factor were also evaluated and compared among treatment options. Pregnancy rates in the CO₂ laser laparoscopy group were significantly higher than in the other three groups and in endometriosis-only subset. Conclusions. Advanced laparoscopic surgery with the CO₂ laser can be more efficient than other modalities in treating infertile women with minimal to mild endometriosis in terms of pregnancy rates. It appears that in experienced hands, laser laparoscopy has more favorable results than the other treatments.