Combined laparoscopic surgery and danazol therapy for pelvic endometriosis.

The role of combined laparoscopic surgery and postoperative danazol treatment for endometriosis in infertile patients has been reviewed in 66 cases. Thirty-five patients with mild endometriosis and twenty-five patients with moderate endometriosis received a standardized laparoscopic surgical procedure followed by danazol therapy with a minimum of 6 months' follow-up. Six patients with severe endometriosis received 4 months of danazol treatment followed by conservative surgery. Fifty-four per cent of these patients conceived, with 92% delivering a live child. By excluding patients with other significant infertility factors, a "corrected" fertility rate of 68% was obtained. The majority of patients conceiving after danazol treatment did so within the first 6 months after therapy. Reported complications to drug treatment were minimal. Second-look laparoscopy when performed in patients who had not conceived within 6 months revealed a significant decrease in residual endometriosis.