Ablation of lesions or no treatment in minimal-mild endometriosis in infertile women: A randomized trial

Fabio Parazzini, Elisabetta Di Cintio, Liliane Chatenoud, Simona Moroni, Italo Ardovino, Elisario Struzziero, Gianluca Bracco, Alessandra Pellegrini, Carlo Bertulessi, Mauro Busacca, Luciano Gruft, Guido Ragni, Marco Massobrio, Cristina Ansaldi, Gian Franco Trossarelli, Enrico Eusebio, Luigi Troiano, Giuseppe Ricci

Research output: Contribution to journalArticle

Abstract

In order to analyse the efficacy of resection/ablation of minimal/mild endometriotic lesions for improving fertility, we conducted a randomized clinical trial. Eligible patients were women aged ≤ 36 years who were trying to conceive and had a laparoscopically confirmed diagnosis of minimal/mild endometriosis (stage I or II of the revised American Fertility Society classification) and otherwise unexplained infertility for ≥ 2 years. Eligible women were randomly assigned to resection or ablation of visible endometriosis (54 patients) or diagnostic laparoscopy only (47 patients). After laparoscopy women tried to conceive spontaneously for 1 year (follow-up period). A total of five women withdrew from the study: three for personal reasons, and two were lost to follow-up. Considering 51 women in the resection/ablation and 45 in the no-treatment group who ended the follow-up period, 12 (24%) in the resection/ablation group and 13 (29%) in the no treatment group conceived; the difference was not significant. Two spontaneous abortions were observed in the resection/ablation group and three in the no-treatment one. Thus the 1 year birth rate was 10 out of 51 women (19.6%) in the resection/ablation group and 10 out of 45 women (22.2%) in the no-treatment group. In conclusion, the results of this study do not support the hypothesis that ablation of endometriotic lesions markedly improves fertility rates.

Original languageEnglish
Pages (from-to)1332-1334
Number of pages3
JournalHuman Reproduction
Volume14
Issue number5
DOIs
Publication statusPublished - 1999

Fingerprint

Endometriosis
Birth Rate
Laparoscopy
Therapeutics
Fertility
Lost to Follow-Up
Spontaneous Abortion
Infertility
Randomized Controlled Trials

Keywords

  • Clinical trial
  • Endometriosis
  • Infertility
  • Laparoscopy

ASJC Scopus subject areas

  • Physiology
  • Developmental Biology
  • Obstetrics and Gynaecology
  • Reproductive Medicine

Cite this

Ablation of lesions or no treatment in minimal-mild endometriosis in infertile women : A randomized trial. / Parazzini, Fabio; Cintio, Elisabetta Di; Chatenoud, Liliane; Moroni, Simona; Ardovino, Italo; Struzziero, Elisario; Bracco, Gianluca; Pellegrini, Alessandra; Bertulessi, Carlo; Busacca, Mauro; Gruft, Luciano; Ragni, Guido; Massobrio, Marco; Ansaldi, Cristina; Trossarelli, Gian Franco; Eusebio, Enrico; Troiano, Luigi; Ricci, Giuseppe.

In: Human Reproduction, Vol. 14, No. 5, 1999, p. 1332-1334.

Research output: Contribution to journalArticle

Parazzini, F, Cintio, ED, Chatenoud, L, Moroni, S, Ardovino, I, Struzziero, E, Bracco, G, Pellegrini, A, Bertulessi, C, Busacca, M, Gruft, L, Ragni, G, Massobrio, M, Ansaldi, C, Trossarelli, GF, Eusebio, E, Troiano, L & Ricci, G 1999, 'Ablation of lesions or no treatment in minimal-mild endometriosis in infertile women: A randomized trial', Human Reproduction, vol. 14, no. 5, pp. 1332-1334. https://doi.org/10.1093/humrep/14.5.1332
Parazzini, Fabio ; Cintio, Elisabetta Di ; Chatenoud, Liliane ; Moroni, Simona ; Ardovino, Italo ; Struzziero, Elisario ; Bracco, Gianluca ; Pellegrini, Alessandra ; Bertulessi, Carlo ; Busacca, Mauro ; Gruft, Luciano ; Ragni, Guido ; Massobrio, Marco ; Ansaldi, Cristina ; Trossarelli, Gian Franco ; Eusebio, Enrico ; Troiano, Luigi ; Ricci, Giuseppe. / Ablation of lesions or no treatment in minimal-mild endometriosis in infertile women : A randomized trial. In: Human Reproduction. 1999 ; Vol. 14, No. 5. pp. 1332-1334.
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abstract = "In order to analyse the efficacy of resection/ablation of minimal/mild endometriotic lesions for improving fertility, we conducted a randomized clinical trial. Eligible patients were women aged ≤ 36 years who were trying to conceive and had a laparoscopically confirmed diagnosis of minimal/mild endometriosis (stage I or II of the revised American Fertility Society classification) and otherwise unexplained infertility for ≥ 2 years. Eligible women were randomly assigned to resection or ablation of visible endometriosis (54 patients) or diagnostic laparoscopy only (47 patients). After laparoscopy women tried to conceive spontaneously for 1 year (follow-up period). A total of five women withdrew from the study: three for personal reasons, and two were lost to follow-up. Considering 51 women in the resection/ablation and 45 in the no-treatment group who ended the follow-up period, 12 (24{\%}) in the resection/ablation group and 13 (29{\%}) in the no treatment group conceived; the difference was not significant. Two spontaneous abortions were observed in the resection/ablation group and three in the no-treatment one. Thus the 1 year birth rate was 10 out of 51 women (19.6{\%}) in the resection/ablation group and 10 out of 45 women (22.2{\%}) in the no-treatment group. In conclusion, the results of this study do not support the hypothesis that ablation of endometriotic lesions markedly improves fertility rates.",
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AU - Chatenoud, Liliane

AU - Moroni, Simona

AU - Ardovino, Italo

AU - Struzziero, Elisario

AU - Bracco, Gianluca

AU - Pellegrini, Alessandra

AU - Bertulessi, Carlo

AU - Busacca, Mauro

AU - Gruft, Luciano

AU - Ragni, Guido

AU - Massobrio, Marco

AU - Ansaldi, Cristina

AU - Trossarelli, Gian Franco

AU - Eusebio, Enrico

AU - Troiano, Luigi

AU - Ricci, Giuseppe

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N2 - In order to analyse the efficacy of resection/ablation of minimal/mild endometriotic lesions for improving fertility, we conducted a randomized clinical trial. Eligible patients were women aged ≤ 36 years who were trying to conceive and had a laparoscopically confirmed diagnosis of minimal/mild endometriosis (stage I or II of the revised American Fertility Society classification) and otherwise unexplained infertility for ≥ 2 years. Eligible women were randomly assigned to resection or ablation of visible endometriosis (54 patients) or diagnostic laparoscopy only (47 patients). After laparoscopy women tried to conceive spontaneously for 1 year (follow-up period). A total of five women withdrew from the study: three for personal reasons, and two were lost to follow-up. Considering 51 women in the resection/ablation and 45 in the no-treatment group who ended the follow-up period, 12 (24%) in the resection/ablation group and 13 (29%) in the no treatment group conceived; the difference was not significant. Two spontaneous abortions were observed in the resection/ablation group and three in the no-treatment one. Thus the 1 year birth rate was 10 out of 51 women (19.6%) in the resection/ablation group and 10 out of 45 women (22.2%) in the no-treatment group. In conclusion, the results of this study do not support the hypothesis that ablation of endometriotic lesions markedly improves fertility rates.

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