Endometriosis and infertility: a review

Area of Science:

• Reproductive Medicine
• Gynecology

Background:

• Endometriosis is a condition where uterine tissue grows outside the uterus, often linked to infertility.
• The precise mechanisms connecting endometriosis and infertility are not fully understood.

Purpose of the Study:

• To review current knowledge on the endometriosis-infertility relationship.
• To outline evidence-based management strategies for endometriosis in infertile patients.

Main Methods:

• A comprehensive literature review of MEDLINE-indexed articles.
• Analysis of studies published between 1960 and 2003.

Main Results:

• Surgical treatment of moderate to severe endometriosis improves monthly fecundity rates.
• For minimal to mild endometriosis, surgical ablation is more effective than watchful waiting.
• Assisted reproductive technologies, including clomiphene citrate with intrauterine insemination (IUI) or gonadotropins with IUI, benefit infertile patients with minimal/mild endometriosis.
• Ovarian suppression is not recommended for asymptomatic, pregnant patients unless part of in vitro fertilization and embryo transfer (IVF/ET).
• Prolonged gonadotropin-releasing hormone analogue suppression may be beneficial before IVF/ET cycles.
• In vitro fertilization (IVF) demonstrates effectiveness in endometriosis patients.

Conclusions:

• Management of endometriosis in infertile women should be tailored to disease severity.
• Surgical and assisted reproductive techniques offer viable options for improving fertility outcomes in endometriosis patients.