Laparotomy in infertility patients with endometriosis. Use of the CO₂ laser

Sixty-eight women underwent laparotomy for endometriosis associated with infertility. They were not candidates for laser laparoscopy by our criteria, or they had failed to conceive after previous therapy. The cumulative pregnancy rate was 70% at 48 months. Patients who failed to conceive after previous medical therapy experienced 44% and 28% term pregnancy rates, respectively, after laparotomy using the CO₂ laser. Thus, for women who have failed to conceive after major surgical procedures, repeat surgery may offer a greater chance of conception than do multiple cycles of in vitro fertilization/embryo transfer.