Endometriosis: medical and surgical intervention.

Pregnancy rates with endometriosis-associated infertility may be improved by laparoscopic surgery or laparotomy for moderate to severe disease. Surgery for minimal to mild disease does not increase pregnancy rates. Medical treatment has not been shown to increase fecundity for any stage of the disease. Pregnancy rates with assisted reproductive technology for endometriosis appear to be comparable with those for tubal disease that are also treated with assisted reproductive technology. Medical and surgical treatments for pelvic pain with endometriosis are both effective, but surgery avoids the side-effects associated with drugs and may result in a lower recurrence rate.