Author(s): Chatterjee S, Dey S, Chowdhury RG
Probably, more has been written and less has been agreed upon, regarding the pathogenesis of the enigmatic disorder--endometriosis, which is the leading cause of disability in women of reproductive age group, resulting in infertility and pelvic pain. It is an accepted fact that the medical treatment of endometriosis does not help in infertility management, except certain situations like pain, limiting the attempt of pregnancy, or endometriosis presenting with cornual block, due to endosalpingiosis. The usual treatment of infertility being either surgical correction, or assisted reproductive technology procedures. In our patient population, the acceptance of In-vitro fertilisation or embryo transfer is much less, because of its high cost and social taboo. In this series, the improved pregnancy outcome is observed with medical treatment of endometriosis with danazol before and after the laparoscopic correction of the tubo-ovarian relation due to endometriosis or in certain cases of minimal to mild endometriosis, not requiring correction. Out of 722 suspected cases of endometriosis, 576 cases were subjected to prelaparoscopic treatment with danazol, and the result was compared with 424 cases of only laparoscopic treatment, and 216 cases of postlaparoscopic danazol treatment, during the years 2004 to 2008. A total of 1216 cases were included in the study. The initiation of medical treatment in the pre-operative period gives better pregnancy outcome, as compared to only surgical or postsurgical medical treatment. The experience proves that the adjuvant medical treatment with danazol, initiated before laparoscopy in suspected endometriosis cases is useful treatment procedure, to increase the pregnancy rate.