The best time to destroy small areas of endometriosis is when
it is diagnosed during laparoscopy (see WebPage 16, Overcoming
Yet many gynecologists dismiss minimal endometriosis as unimportant in causing
infertility. (Remember that the more substantial endometriosis is, the more successful
an operation will be in improving fertility.)
This important multi-center trial from Canada shows that treating minimal endometriosis
at laparoscopy doubles the chance of getting pregnant naturally, compared with
Dr Sylvie Marcoux from Quebec and many colleagues studied 341 infertile women aged
between 20 and 39. They were followed for 36 weeks after the laparoscopy.
If you've read Appendix A of the book, you'll understand life-table curves ....
"the accumulating chance of having gotten pregnant", as months go by.
The Canadian authors use such graphs to show the difference between the women who were
randomized to have their endometriosis lesions cauterized and the women who were
randomized to no treatment:
What this means is that 12 months after your diagnostic laparoscopy (assuming that
minimal or mild endometriosis was found) you would have had an 8% chance of being
pregnant successfully if nothing was done, but a 19% chance of being successfully
pregnant if the endometriosis was treated.
The per-month chance of getting pregnant (the fecundability or monthly fertility rate)
was 6% with treatment at laparoscopy, 3 % without.
Sure, there's more chance of getting pregnant with one cycle of IVF in a good program,
but IVF can be expensive. And if you are having the laparoscopy anyway, this study
proves that it is better to have the endometriosis treated on the spot.
The graph in Appendix A of the book gives the vertical axis as a proportion (from 0
to 1.0); as a percentage, this would be 0 to 100%.
Note that in the authors' diagram (which I have redrawn), the vertical axis is limited
to 0 to 35%.
For more on endometriosis, visit WebPages
15 and 16 on the main site.
the article's abstract at the National Library of Medicine.
Order the U.S. version of
the book from Amazon Books or Barnes and Noble.