Minimal and mild endometriosis. Nd:YAG laser treatment and changes in prostaglandin concentrations in peritoneal fluid.

Among many patients, infertility originates with minimal and mild endometriosis. Recently, peritoneal fluid factors have come to be associated with infertility in minimal and mild endometriosis patients, and prostaglandin (PG) is suspected of being one of those factors. We use the Nd:YAG laser for treatment of endometriosis; a total of 52 cases of minimal and mild endometriosis have been treated so far with the laser under laparoscopy in our clinic. At the same time we measured the peritoneal fluid volume and PG concentration in peritoneal fluid. Peritoneal fluid volume and PGE2 concentrations were found to be significantly higher than those in the control group (tubal obstruction patients). Seven of 52 patients received second-look laparoscopy three months after Nd:YAG laser treatment; the PG concentration showed a tendency to decrease in many patients, and the PGE2 concentration turned out to be insignificant. Within one year, 30 patients achieved pregnancy. In minimal and mild endometriosis patients Nd:YAG laser treatment may alter the PG concentration in peritoneal fluid, thereby increasing the change of pregnancy.