Pertubation with Lignocaine – a Possible New Treatment for Women with Endometriosis and Impaired Fertility

Abstract

The causal relationship between reduced fertility and early stage endometriosis without pelvic adhesions is unclear. Peritoneal fluid from patients with endometrial peritoneal implants contains more leukocytes with an increased capacity to phagocytose spermatozoa. Peritoneal fluid supplemented with lignocaine has a reduced sperm phagocytosis capacity. The present clinical study with low-dose lignocaine pertubation sought to evaluate any clinical effect on fertility. An overall pregnancy rate of 30% was noted in contrast to the natural pregnancy rate for women with endometriosis which is <5%. To confirm these findings a larger study and further dose-ranging are in progress. Up to now the most effective way of increasing fertility for women with endometriosis or unexplained infertility is in vitro fertilisation (IVF). The pertubation treatment with lignocaine is inexpensive and less invasive. Its mechanism is thought to be reduced phagocytosis of the spermatozoa. Another explanation could be a regressive effect directly on the endometriotic implants, taking into account the reduced menstrual pain and increased pregnancy rate after all treatments have been completed. The finding may provide a minimal invasive and more cost-effective alternative to current treatments.