[Ovarian stimulation regimens in women with endometriosis]

Controversies concerning the optimal treatment of endometriosis and its related infertility still exist, and few comparative studies are available. The number of oocytes retrieved and pregnancy rates seem to be higher after in vitro fertilization that follows long-term down-regulation with Gn-RH agonists, but the available studies are retrospective and do not allow definitive conclusion. No comparative studies are available between extra long and short Gn-RH agonist in women affected by endometriosis. No benefit of the use of danazol has been demonstrated in this indication. There are no data available on Gn-RH antagonist pretreatment before ovarian stimulation in patients with endometriosis undergoing assisted reproduction techniques. Endometrioma resection prior to IVF may compromise or destroy adjacent normal ovarian cortex and thus might reduce the ovarian reserve. Aspiration of endometrioma is associated with an increased risk of infection.