Surgical management of infertile women with minimal to mild endometriosis is controversial. Based on the results of a meta-analysis of two randomized trials, ablation of endometriotic lesions plus adhesiolysis to improve fertility in minimal to mild endometriosis is effective compared to diagnostic laparoscopy alone (191,192,435). One Canadian study reported that laparoscopic surgery enhanced fecundity in infertile women with minimal or mild endometriosis (191). They studied 341 infertile women, 20 to 39 years of age, with minimal or mild endometriosis. During diagnostic laparoscopy, the women were randomly assigned to undergo resection or ablation of visible endometriosis or diagnostic laparoscopy only. They found that resection or ablation of minimal and mild endometriosis increased the likelihood of pregnancy in infertile women. They were followed for 36 weeks after the laparoscopy or, for those who became pregnant during that interval, for up to 20 weeks of pregnancy. The study participants were recruited among infertile women scheduled for diagnostic laparoscopy with strict eligibility criteria. The women in the study had no previous surgical treatment for endometriosis, no medical treatment for endometriosis in the previous 9 months, and no other medical or surgical treatment for infertility in the previous 3 months. They had no history of pelvic inﬂammatory disease and no severe pelvic pain precluding expectant management. The diagnosis of endometriosis required the presence of one or more typical bluish or black lesions. The stage of endometriosis was determined according to the revised American Society of Reproductive Medicine classification. Both the monthly fecundity rate and the cumulative pregnancy rate after 36 weeks were significantly higher and twice as high after surgical excision of minimal to mild endometriosis (4.7% and 30.7%, respectively) than after diagnostic laparoscopy (2.4% and 17.7%, respectively). In the treated group, 31% of the patients became pregnant, compared with 18% in the nontreated group (p = 0.006). Limitations of this study include the lack of blinding of the patients, and the fecundity rate after surgery was below that observed in control groups from other studies (1,436).