Endometriosis and infertility: a committee opinion

Capsule:
The purpose of this document is to summarize the current therapies for endometriosis.

Author:
The Practice Committee of the American Society for Reproductive Medicine

Volume 98, Issue 3, Pages 591-598, September 2012

Abstract:
Women with endometriosis typically present with pelvic pain, infertility or an adnexal mass, and may require surgery. Treatment of endometriosis in the setting of infertility raises a number of complex clinical questions that do not have simple answers. This document replaces the 2006 ASRM Practice Committee document of the same name.

  • j.utah

    This a excellent review of the literature and resource for providers. Does anyone have a proposed mechanism for why pretreatment with GnRH agonist improves pregnancy rates in women with endometriosis undergoing IVF but a similar benefit is not observed when used prior to natural conception cycles?

    • one big confounder is the time impact of gnrh-a treatment when used for non-ivf… the delay in treatment leads to lower pregnancy plus the agonist does not fix the structural alteration and scar of endo/tubal disease. so short term use for IVF isolates effects on gametes and implantation

  • Treating infertility couples with endometriosis can be very complicated. This article provides great guidlines for practices including how to manage endometriomas before an IVF cycle. Any thoughts on whether or not a patient with Stage III/IV endo will benefit from surgical removal of endo before going into an IVF cycle?

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