{"paper_id":"0c2641e0-8562-426b-a4d7-30852a995bf0","body_text":"Abstract\nDespite many years of investigations and clinical trials, treatment of endometriosis-associated infertility remains controversial. A plethora of therapeutic approaches have been suggested including expectant management, medical intervention, major conservative surgery, and laparoscopic resection.1\nPreview\nUnable to display preview. Download preview PDF.\nSimilar content being viewed by others\nReferences\nOlive DL, Haney AF. Endometriosis-associated infertility: A critical review of therapeutic approaches. Obstet Gynecol Surv 1986;41:538.\nMetzger DA, Haney AF. Endometriosis: Etiology and pathophysiology of infertility. Clin Obstet Gynecol 1988; 31:801.\nMetzger DA, Luciano AA. Hormonal therapy of endometriosis. Obstet Gynecol Clin NA 1989;16:105.\nEvers JLH. The second-look laparoscopy for evaluation of the results of medical treatment of endometriosis should not be performed during ovarian suppression. Fertil Steril 1987;47:502–504.\nNisolle-Pochet M, Casanas-Roux F, Donnez J. Histologic study of ovarian endometriosis after hormonal therapy. Fertil Steril 1988;49:423.\nOlive DL, Martin DC. Treatment of endometriosis-associated infertility with CO2 laser laparoscopy: the use of one- and two-parameter exponential models. Fertil Steril 1987;48:18.\nStrathy JH, Molgaard CA, Coulam CB, et al. Endometriosis and infertility: a laparoscopic study of endometriosis among fertile and infertile women. Fertil Steril 1982;38:66.\nTulandi T, Mouchawar M. Treatment-dependent and treatment-independent pregnancy in women with minimal and mild endometriosis. Fertil Steril 1991;56:790.\nGrant A. Additional sterility factors in endometriosis. Fertil Steril 1966;17:514.\nGast MJ, Tobler R, Strickler RC, et al. Laser vaporization of endometriosis in an infertile population: the role of complicating infertility factors. Fertil Steril 1988;49:32.\nMurphy AA, Schlaff WD, Hassiakos D, et al. Laparoscopic cautery in the treatment of endometriosis-related infertility. Fertil Steril 1991;55:246.\nPortuondo JA, Eschanojauregui AD, Herran C. Early conception in patients with untreated mild endometriosis. Fertil Steril 1983;39:22.\nJansen RPS. Minimal endometriosis and reduced fecun-dability: prospective evidence from an artificial insemination by donor program. Fertil Steril 1986;46:141.\nJones HW, Anibal AA, Andrews MC, et al. Three years of in vitro fertilization at Norfolk. Fertil Steril 1984; 42:826.\nDodson WC, Whitesides DB, Hughes CL Jr, et al. Superovulation with intrauterine insemination in the treatment of infertility: a possible alternative to gamete intrafallopian transfer and in vitro fertilization. Fertil Steril 1987;48:441.\nChaffkin LM, Nulsen JC, Luciano AA, et al. A comparative analysis of the cycle fecundity rates associated with combined human menopausal gonadotropin (hMG) and intrauterine insemination (IUI) versus either hMG or IUI alone. Fertil Steril 1991;55:252.\nLuciano AA, Marana R, Kratka S, et al. Ovarian function after incision of the ovary by scalpel, CO2 laser and microelectrode. Fertil Steril 1991;56:349.\nFortier KJ, Haney AF. The pathologic spectrum of uterotubal unction obstruction. Obstet Gynecol 1985; 65:93.\nMoon YS, Leung PCS, Yuen BH, et al. Prostaglandin F in human endometriotic tissue. Am J Obstet Gynecol 1981;141:344.\nBadawy SZA, Marshall L, Gabal AA, et al. The concentration of 13, 14-dihydro-15-keto prostaglandin F2 and prostaglandin E2 in peritoneal fluid of infertile patients with and without endometriosis. Fertil Steril 1982;38:166.\nDrake TS, O’Brien WF, Ramwell PW. Peritoneal fluid thromboxane B2 and 6-ketoprostaglandin F1 in endometriosis. Am J Obstet Gynecol 1981;140:401.\nDawood MY, Khan-Dawood FS, Wilson L. Peritoneal fluid prostaglandins and prostanoids in women with endometriosis, chronic pelvic inflammatory disease and pelvic pain. Am J Obstet Gynecol 1984;148:391.\nRock JA, Dubin NH, Ghodgaonkar RB, et al. Cul-de-sac fluid in women with endometriosis: fluid volume and prostanoid concentration during the proliferative phase of the cycle days 8 to 12. Fertil Steril 1982;37:747.\nHalme J, Becker S, Hammond MG, et al. Increased activation of pelvic macrophages in infertile women with mild endometriosis. Am J Obstet Gynecol 1983;145:333.\nHaney AF, Muscato JJ, Weinberg JB. Peritoneal fluid cell populations in infertility patients. Fertil Steril 1981; 35:696.\nCroxatto HB, Ortiz ME, Guiloff E, et al. Effect of 15 (s)-15-methyl-prostaglandin F2 on human oviductal motility and ovum transport. Fertil Steril 1978;30:408.\nPittaway DE, Maxson W, Daniell J, et al. Luteal phase defects in infertility patients with endometriosis. Fertil Steril 1983;39:712.\nWinkel CA, Opsahl MS, Cowan BD. Clomiphene citrate treatment failures in women with endometriosis and luteal dysfunction. Fertil Steril 1984;41:645.\nSchenken RS, Asch RH, Williams RF, et al. Etiology of infertility in monkeys with endometriosis: luteinized unruptured follicles, luteal phase defects, pelvic adhesions and spontaneous abortions. Fertil Steril 1984; 41:122.\nCheesman KL, Cheesman SD, Chatterton RT, et al. Alterations in progesterone metabolism and luteal function in infertile women with endometriosis. Fertil Steril 1983;43:590.\nCheesman KL, Ben-Nun I, Chatterton RT, et al. Relationship of luteinizing hormone, pregnanediol-3-glucouronide and estriol-16-glucouronide in urine of infertile women with endometriosis. Fertil Steril 1982; 38:542.\nMetzger DA, Olive DL, Stohs GF, et al. Association of endometriosis and spontaneous abortion: effect of control group selection. Fertil Steril 1986;45:18.\nFitz Simmons J, Stahl R, Gocial B, et al. Spontaneous abortion and endometriosis. Fertil Steril 1987;47:696.\nDonnez J, Langerock S, Thomas K. Peritoneal fluid volume, 17 beta-estradiol and progesterone concentrations in women with endometriosis and/or luteinized unruptured follicle syndrome. Gynecol Obstet Invest 1983;16:210.\nMarik J, Hulka J. Luteinized unruptured follicle syndrome: a subtle case of infertility. Fertil Steril 1978; 29:270.\nDmowski WP, Rao R, Scommegna A. The luteinized unruptured follicle syndrome and endometriosis. Fertil Steril 1980;33:30.\nDaly DC, Soto-Albors C, Walters C, et al. Ultrasonographic assessment of luteinized unruptured folilcle syndrome in unexplained infertility. Fertil Steril 1985; 43:62.\nBrosens IA, Koninckx PR, Corveleyn PA. A study of plasma progesterone, oestradiol-17B, prolactin, and LH levels and of the luteal-phase appearance of the ovaries in patients with endometriosis and infertility. Br J Obstet Gynaecol 1978;85:246.\nKoninckx PR, Ide P, Vandebrouke W, et al. New aspects of the pathophysiology of endometriosis and associated infertility. J Reprod Med 1980;24:257.\nVanrell JA, Belasch J, Fuster JS, et al. Ovulation stigma in fertile women. Fertil Steril 1982;37:712.\nKerin JF, Kirby C, Morris D, et al. Incidence of the luteinized unruptured follicle syndrome in cycling women. Fertil Steril 1983;40:620–626.\nWeed JC, Arquembourg PC. Endometriosis: can it produce an autoimmune response resulting in infertility? Clin Obstet Gynecol 1988;23:885.\nMathur S, Peress MR, Williamson HO, et al. Autoimmunity in endometrium and ovary in endometriosis. Clin Exp Immunol 1982;50:259.\nKreiner D, Frommowitz FB, Richardson DA. Endometrial immunofluorescence associated with endometriosis and pelvic inflammatory disease. Fertil Steril 1986; 46:243.\nWild RA, Shivers CA. Antiendometrial antibodies in patients with endometriosis. Am J Reprod Immunol Microbiol 1985;8:84.\nHalme J, Mathur S. Local autoimmunity in mild endometriosis. Int J Fertil 1987;32:309.\nSaifuddin A, Buckley CH, Fox H. Immunoglobulin content of the endometrium in women with endometriosis. Int J Gynecol Path 1983;2:255.\nGrimes DA, LeBolt SA, Grimes KR, et al. Systemic lupus erythematosus and reproductive function: A case-control study. Am J Obstet Gynecol 1985;153:179.\nGleicher N, El-Roliy A, Confino E, et al. Is endometriosis an autoimmune disease? Obstet Gyencol 1987; 70:115.\nDrake T, O’Brien W, Grunert G, et al. Peritoneal fluid volume in endometriosis. Fertil Steril 190;34:280.\nFakih H., Baggett B, Holtz G, et al. Interleukin-1: a possible role in the fertility associated with endometriosis. Fertil Steril 1987;47:213.\nVanFurth R, Raeburn JA, van Zwet TI. Characteristics of human mononuclear phagocytes. Blood 1979;54:485.\nAustin CR. Fate of spermatozoa in the female genital tract. J Reprod Fertil 1960;1:151.\nHoxsey RJ, Rao R, Scommegna A. Sperm recovery in peritoneal fluid of endometriosis versus “normal” infertile patients. Fertil Steril 1984;41:395.\nMuscato JJ, Haney AF, Weinberg JB. Sperm phagocytosis by human peritoneal macrophages: a possible cause of infertility in endometriosis. Am J Obstet Gynecol 1982;144:503.\nChacho KJ, Chacho MS, Anderson PJ, et al. Peritoneal fluid in patients with and without endometriosis: prostanoids and macrophages and their effect on the spermatozoa penetration assay. Am J Obstet Gynecol 1986; 154:1290.\nSteinleitner A, Lambert H, Suarez M, et al. Immunomodulation in the treatment of endometriosis-associated subfertility: use of pentoxifylline to reverse the inhibition of fertilization by surgically induced endometriosis in a rodent model. Fertil Steril 1991a;56:975.\nSteinleitner A, Lambert H, Roy S. Immunomodulation with pentoxifylline abrogates macrophage-mediated infertility in an in vivo model: a paradigm novel approach to the treatment of endometriosis-associated subfertility. Fertil Steril 1991b;55:26.\nFayez JA, Collazo LM, Vernon C, et al. Comparison of different modalities of treatment for minimal and mild endometriosis. Am J Obstet Gynecol 1988;159:927.\nNowroozi K, Chase JS, Check JH, et al. The importance of laparoscopic coagulation of mild endometriosis in infertile women. Int J Fertil 1987;32:442.\nAdamson GD, Lu J, Subak LL. Laparoscopic CO2 laser vaporization of endometriosis compared with traditional treatments. Fertil Steril 1988;50:704.\nOlive DL, Lee KL. Analysis of sequential treatment protocols for endometriosis-associated infertility. Am J Obstet Gynecol 1986;154:613.\nDiamond MP and the Adhesion Study Group. Postoperative adhesion development after operative lap-aroscopy: evaluation at early second-look procedures. Fertil Steril 1991;55:700.\nDiamond MP, Daniell JF, Feste J, et al. Adhesion reformation and de novo adhesion formation after reproductive surgery. Fertil Steril 1987;47:864.\nNezhat C, Nezhat F, Metzger DA, et al. Adhesion reformation following reproductive surgery by video-laseroscopy. Fertil Steril 1990;53:1008.\nLuciano AA, Turksoy RN, Carleo J. Evaluation of oral medroxyprogesterone acetate in the treatment of endometriosis. Obstet Gynecol 1988;72:323.\nEvers JLH, Dunselman GAJ, Land JA, et al. Endometriosis: The management of recurrent disease. In Shaw RW, ed. Endometriosis. Carnforth, Parthenon 1990, pp 93–105.\nSilverberg KM. Combination therapy for endometriosis. Infertil Reprod Med Clin NA 1992;3:683.\nButtram VC, Reiter RC, Ward S. Treatment of endometriosis with danazol: Report of a 6 year prospective study. Fertil Steril 1985;43:353.\nDonnez J, Nisolle M, Clerckx F, et al. Evaluation of peroperative use of danazol, gestrinone, lynestrenol, buserelin spray and buserelin implant in the treatment of endometriosis-associated infertility. Prog Clin Biol Res 1990;323:427.\nTelimmaa S, Puolakka J, Ronnberg L, et al. Placebo-controlled comparison of danazol and high-dose medroxy- progesterone acetate in the treatment of endometriosis. Gynecol Endocrinol 1987;1:13.\nChong AP, Koene ME, Thornton NL. Comparison of three modes of treatment for infertility patients with minimal pelvic endometriosis. Fertil Steril 1990;53:40.\nWheeler JM, Malinak LR. Recurrent endometriosis: Incidence, management and prognosis. Am J Obstet Gynecol 1983;146:247.\nSchenken RS, Malinak LR. Reoperation after initial treatment of endometriosis with conservative surgery. Am J Obstet Gynecol 1978;131:416.\nCandiani GB, Fedele L, Vercellini P, et al. Repetitive conservative surgery for recurrence of endometriosis. Obstet Gynecol 1991;77:421.\nSyrop CH, Halme J. Peritoneal fluid environment and infertility. Fertil Steril 1987;48:1.\nDeaton JL, Gibson M, Blackmer KM, et al. A randomized, controlled trial of clomiphene citrate and intrauterine insemination in couples with unexplained infertility or surgically corrected endometriosis. Fertil Steril 1990; 54:1083.\nMetzger DA, Robbins B, Tortora A, et al. Clomiphene citrate (CC) and intrauterine insemination (IUI) for the treatment of infertility. Society for Gynecologic Investigation, April 1–3, 1993, Toronto, Canada, Abstract #347.\nNulsen JC, Dumez S, Metzger DA. A randomized prospective trial of human menopausal gonadotropin (hMG) with intrauterine insemination (IUI) versus IUI alone in the treatment of endometriosis, male factor infertility and unexplained infertility. Obstet Gynecol (in press).\nMetzger DA, Scott L, Nulsen JC, et al. Optimal use of human menopausal gonadotropin (hMG) superovulation combined with intrauterine insemination (IUI) as an adjunct to conservative laparoscopic surgery for the treatment of infertility associated with endometriosis. The American Association of Gynecologic Laparoscop-ists, 20th Annual Meeting, Las Vegas, NV, Nov. 13–17, 1991.\nJacobs SL, Metzger DA, Dodson WC, Haney AF. Effect of age on response to human menopausal gonadotropin stimulation. J Clin Endo Metab 1990;71:1525.\nIVF Registry, 1991. Fertil Steril 1993;59:956.\nHulme VA, van der Merwe JP, Kruger TF. Gamete intrafallopian transfer as treatment for infertility associated with endometriosis. Fertil Steril 1990;53(6): 1095–1096.\nCorson SL, Batzer FR, Gocial B, et al. Surgical treatment of endometriosis at the time of gamete intrafallopian transfer. J Repro Med 1991; 36(4):274–278.\nBatzofin J, Tran C, Tan T, et al. Laser laparoscopy as an adjunct to assisted reproductive treatments in women with pelvic adhesions and endometriosis. J Gynecol Surg 1989;5:273.\nRemorgida V, Anserini P, Croce S, et al. Comparison of different ovarian stimulation protocols for gamete intrafallopian transfer in patients with minimal and mild endometriosis. Fertil Steril 1990;53:1060.\nMaison PL, Yovick JL. The treatment of infertility associated with endometriosis by in vitro fertilization. Fertil Steril 1986;46:432.\nYovick JL, Maison PL, Richardson PA, Hilliard C. Hormonal profiles and embryo quality in women with severe endometriosis treated by in vitro fertilization and embryo transfer. Fertil Steril 1988;50:308.\nChillik CF, Acosta AA, Garcia JE, et al. The role of in vitro fertilization in infertile patients with endometriosis. Fertil Steril 1985;44:56.\nOehninger S, Rosenwaks A. In vitro fertilization and embryo transfer: an established and successful therapy for endometriosis. Prog Clin Biol Res 1990;323:319.\nDamewood MD, Rock JA. Treatment independent pregnancy with operative laparoscopy for endometriosis in an in vitro fertilization program. Fertil Steril 1988; 50:463.\nManzi DM, Metzger DA, Luciano AA, et al. The efficacy of IVF as a treatment modality for individuals with endometriosis previously failing hMG/IUI super-ovulation therapy (in preparation).\nClassification of endometriosis. American Fertility Society. Fertil Steril 1979;32:633.\nGarcia CR, David SS. Pelvic endometriosis: infertility and pelvic pain. Am J Obstet Gynecol 1977;129:740.\nSadigh H, Naples JD, Batt RE. Conservative surgery for endometriosis in the infertile couple. Obstet Gynecol 1977;49:562.\nButtram VC. Conservative surgery for endometriosis in the infertile female: a study of 206 patients with implications for both medical and surgical therapy. Fertil Steril 1979;31:117.\nRock JA, Guzick DS, Sengoes C, et al. The conservative surgical treatment of endometriosis: evaluation of pregnancy success with respect to the extent of disease as categorized using contemporary classification systems. Fertil Steril 1981;35:131.\nSchenken RS, Malinak LR. Conservative surgery versus expectant management for the infertile patient with mild endometriosis. Fertil Steril 1982;37:183.\nRantala ML, Kahanpaa KV, Koskimies A, et al. Fertility prognosis after surgical treatment of pelvic endometriosis. Acta Obstet Gynecol Scand 1983;61:11.\nGordts S, Boeckx W, Brosens I. Microsurgery of endometriosis in infertile patients. Fertil Steril 1984,42:520.\nKelly RW, Roberts DK. CO2 laparoscopy. A potential alternative to danazol in the treatment of stage I and II endometriosis. J Reprod Med 1983;28:638.\nFeste JR. Laser laparoscopy: a new modality. J Reprod Med 1985;30:413.\nMartin DC. CO2 laser laparoscopy for endometriosis associated with infertility. J Reprod Med 1986;31:1089.\nDavis GD. Management of endometriosis and its associated adhesions with the CO2 laser laparoscope. Obstet Gynecol 1986;68:422.\nDonnez J. CO2 laser laparoscopy in infertile women with endometriosis and women with adnexal adhesions. Fertil Steril 1987;48:390.\nSutton C, Hill D. Laser laparoscopy in the treatment of endometriosis. A 5-year study. Br J Obstet Gynaecol 1990;97:181.\nNezhat C, Crowgey S, Nezhat F. Videolaseroscopy for the treatment of endometriosis associated with infertility. Fertil Steril 1989;51:237.\nPaulson JD, Asmar P, Saffan DS. Mild and moderate endometriosis. Comparison of treatment modalities for infertile couples. J Reprod Med 1991;36:151.\nEward RD. Cauterization of stages I and II endometriosis and the resulting pregnancy rate. In Philips JM, ed. Endoscopy in Gynecology: the Proceedings of the Third International Congress on Gynecologic Endoscopy. Downey, CA, American Association of Gynecologic Laparoscopists, 1978, p 276.\nSulewski JM, Curcio FD, Bronitsky C, et al. The treatment of endometriosis at laparoscopy for infertility. Am J Obstet Gynecol 1980;138:128.\nSeiler JC, Gidwani G, Ballard L. Laparoscopic cauterization of endometriosis for fertility: a controlled study. Fertil Steril 1986;46:1098.\nDaniell JF, Christianson C. Combined laparoscopic surgery and danazol therapy for pelvic endometriosis. Fertil Steril 1981;35:521.\nBarbieri RL, Evans S, Kistner RW. Danazol in the treatment of endometriosis: Analysis of 100 cases with a 4-year follow-up. Fertil Steril 1982;37:737.\nDonnez J, Lemaire-Rubbers M, Karaman Y, et al. Combination (hormonal and microsurgical) therapy in infertile women with endometriosis. Fertil Steril 1987; 48:239.\nAndrews WC, Larsen DC. Endometriosis: Treatment with hormonal psuedopregnancy and/or operation. Am J Obstet Gynecol 1974;118:643.\nHammond CB, Rock JA, Parker RT. Conservative treatment of endometriosis: The effects of limited surgery and hormonal pseudopregnancy. Fertil Steril 1976; 27:756.\nHammond MG, Hammond CB, Parker RT. Conservative treatment of endometriosis extera: The effects of methyltestosterone therapy. Fertil Steril 1978;29:651.\nAudebert AJM, Larrue-Charlus S, Emperaire JC. Endometriosis and infertility. A reveiw of sixty-two patients treated with danazol. Postgrad Med J 1979; 55(Suppl. 5):10.\nWheeler JM, Malinak LR. Postoperative danazol therapy in infertility patients with severe endometriosis. Fertil Steril 1981;36:460.\nChong AP, Baggish MS. Management of pelvic endometriosis by means of intraabdominal carbon dioxide laser. Fertil Steril 1984;41:14.\nChong AP. Danazol versus carbon dioxide laser plus postoperative danazol: Treatment of infertility due to mild pelvic endometriosis. Lasers Surg Med 1985;5: 571.\nRonnberg L, Javiner PA. Pregnancy rates following various therapy modes for endometriosis in infertile patients. Acta Obstet Gynecol Scan Suppl 1984;123: 69.\nMettler L, Semm K. Three-step therapy of genital endometriosis in cases of human infertility with lynestrenol, danazol, or gestrinone administration in the second step. In Raynaud JP, ed. Medical Management of Endometriosis. New York, Raven Press, 1984, pp 233–248.\nEditor information\nEditors and Affiliations\nRights and permissions\nCopyright information\n© 1995 Springer-Verlag New York, Inc.\nAbout this chapter\nCite this chapter\nMetzger, D. (1995). Treatment of Infertility Associated With Endometriosis. In: Nezhat, C.R., Berger, G.S., Nezhat, F.R., Buttram, V.C., Nezhat, C.H. (eds) Endometriosis. Springer, New York, NY. https://doi.org/10.1007/978-1-4613-8404-5_25\nDownload citation\nDOI: https://doi.org/10.1007/978-1-4613-8404-5_25\nPublisher Name: Springer, New York, NY\nPrint ISBN: 978-1-4613-8406-9\nOnline ISBN: 978-1-4613-8404-5\neBook Packages: Springer Book Archive\nKeywords\nThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.","source_license":"CC0","license_restricted":false}