Does ovulation stimulation improve fertility in women with minimal/mild endometriosis after laser laparoscopy?

Cycle fecundity was retrospectively analyzed in a group of infertile women after minimal/mild endometriosis had been treated by carbon dioxide laser laparoscopy. Patients were followed in spontaneous (observation) cycles as well as in treatment cycles using ovulation stimulation. Treatment protocols included clomiphene citrate (CC), sequential CC/human menopausal gonadotropins/human chorionic gonadotropin (CC/hMG/hCG), and hMG/hCG. Some patients who failed to conceive with ovulation stimulation protocols underwent in vitro fertilization (IVF). Eighty-nine patients were followed for a total of 605 cycles, during which 37 pregnancies occurred. Cycle fecundity was 0.028 in observation cycles, and was higher with the use of CC (0.066), and significantly higher (P < .05) with use of CC/hMG/hCG (0.114) and hMG/hCG (0.073). The highest cycle fecundity was attained in IVF cycles (0.222). This retrospective analysis suggests that active ovulation management in patients with minimal/mild endometriosis treated by carbon dioxide laser laparoscopy may significantly increase cycle fecundity.