Expectant management and hydrotubations in the treatment of endometriosis-associated infertility.

One hundred twenty-three infertility patients with laparoscopically documented endometriosis were managed expectantly for an interval of 1 to 25 months. Analysis revealed an overall pregnancy rate of 24.4% and a monthly fecundity rate (MFR) of 3.1%. Patients with mild disease had an overall pregnancy rate of 52.9% and an MFR of 5.7%. Women with moderate endometriosis did less well, but still demonstrated a pregnancy rate of 25% and an MFR of 3.2%. No pregnancies occurred with severe disease and expectant management. Postlaparoscopic hydrotubation was evaluated for its therapeutic effect with the use of multivariate analysis and maximum likelihood analysis. The results indicate that there is no decrease in the laparoscopy to conception interval, whereas a potential increase in cure rate cannot be adequately evaluated at this time.