{"paper_id":"1ce60a89-8b48-4933-b8bb-d3ea8178011e","body_text":"Abstract\nAn association between endometriosis and infertility has been confirmed by a large number of studies, although mechanisms are still debated. The availability of in vitro fertilization represented a major step forward in achieving pregnancy in women with endometriosis, although in both peritoneal and ovarian disease, there is an adverse effect on ovulation rates, markers of ovarian reserve, and response to ovarian stimulation. Results have improved using intracytoplasmic sperm injection.\nWhen achieved, pregnancy may be complicated by spontaneous hemoperitoneum, a rare but potentially fatal event. Data on incidence of preeclampsia, small for gestational age (SGA), and preterm birth are not univocal. A large cohort study found an increased risk of preterm birth; another observed no evidence for an association between endometriosis and risk of pregnancy hypertension, or preeclampsia; a third found increased rates of both preterm birth and SGA. In pregnancies complicated by the presence of ovarian endometrioma no differences have been observed in late pregnancy and neonatal outcomes.\nEndometriosis patients seem to be at an increased risk of placenta previa and postpartum hemorrhage. An association has been found also when pregnancy is achieved through in vitro fertilization, suggesting that events around the time of implantation may be responsible.\nWith regard to pathophysiology, the hypothesis has been proposed that defective spiral artery remodeling may be the cause of major obstetrical syndromes in endometriosis and adenomyosis and that endometrial and myometrial junctional zone (MJZ) abnormalities represent a risk factor for the vascular development of the placental bed.\nAvailable evidence supports the idea of a reversibility of MJZ changes by appropriate medication inducing a prolonged hypoestrogenic period.\nAccess this chapter\nTax calculation will be finalised at checkout\nPurchases are for personal use only\nSimilar content being viewed by others\nReferences\nMcGoogan LS. Sterility and endometriosis. Arch Surg. 1949;59:437–44.\nKistner RW. Endometriosis and infertility. 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Springer, Tokyo. https://doi.org/10.1007/978-4-431-54421-0_28\nDownload citation\nDOI: https://doi.org/10.1007/978-4-431-54421-0_28\nPublished:\nPublisher Name: Springer, Tokyo\nPrint ISBN: 978-4-431-54420-3\nOnline ISBN: 978-4-431-54421-0\neBook Packages: MedicineMedicine (R0)","source_license":"CC0","license_restricted":false}