A Cochrane review «»? (abstract «»1, review «Laparoscopic surgery for endometriosis»?) included 3 studies with a total of 535 subjects. Compared with diagnostic laparoscopy, laparoscopic surgery was associated with an increased viable intrauterine pregnancy confirmed by ultrasound (OR 1.89, 95% CI 1.25 to 2.86; 3 RCTs, n=528).
A retrospective cohort study «Soriano D, Adler I, Bouaziz J et al. Fertility outcome of laparoscopic treatment in patients with severe endometriosis and repeated in vitro fertilization failures. Fertil Steril 2016;106(5):1264-1269»2 included all women (n=78) who failed IVF treatment before surgery and who underwent laparoscopic surgery for severe endometriosis between January 2006 and December 2014. After surgical treatment 33 women (42.3%) delivered. Three women (9%) conceived spontaneously and all other women conceived after IVF treatment. In addition, performing salpingectomy during surgery was associated with a trend of improvement in delivery rates after surgery (70% in women who delivered vs. 51% in women who failed to deliver).
Comment: The quality of evidence is downgraded by imprecise results (few outcome events).