The second-look laparoscopy for evaluation of the result of medical treatment of endometriosis should not be performed during ovarian suppression

Abstract

Some authors have evaluated the efficacy of medical treatment for endometriosis by SLL at termination of therapy. The appearance of endometriotic lesions depends on ovarian activity. We studied the appearance of endometriotic lesions at SLL during the last week of treatment with danazol and compared it with the appearance of SLL in the second cycle after the end of treatment. A difference was noted and was attributed to the effect of stimulation of the endometriotic foci by ovarian activity. Danazol does not eradicate endometriosis. When suppression is discontinued, the disease will return with time. We conclude that performing an SLL during ovarian suppression, for evaluation of the effect of medical therapy of endometriosis, is a misleading procedure.