LAPAROSCOPIC TREATMENT OF SYMPTOMATIC ENDOMETRIOSIS

From their experience and from data in the literature, the authors try to define the respective place of the different treatments for endome triosis, especially those of operative laparoscopy. In cases of endome triosis-associated infertility, operative laparoscopy is the first lin e treatment and assisted reproductive technology (ART) the second one. Gonadotrophin-releasing hormone (GnRH) analogues are only useful in c ases of extensive endometriosis to render surgery easier, and for ART. The average pregnancy rate following laparoscopic treatment is simila r to 50% (range 34-80%). It is poorly related to the type of endometri osis except in cases of large adhesions and tubal involvement. However , duration of infertility, age and sperm quality have a direct influen ce on it. Therefore the authors propose a scheme for the management of endometriosis-associated infertility. In cases of pain, laparoscopic surgery can also be used however, drugs have a more important role in these cases, to avoid recurrent surgery.