{"paper_id":"205c228e-7f8e-4c7e-ac77-fa1167286df6","body_text":"Abstract\nEndometriosis is one of the main causes of infertility, although the actual relationship between both is unclear and poorly understood. The association between severe and advanced endometriosis and reduced fertility may be explained through the severe anatomical and functional abnormalities caused by advanced endometriosis in the female pelvis. These patients also have significantly lower ovarian reserve markers, regardless of previous ovarian surgery. In large studies the prevalence of endometriosis in fertile women appears to be lower (0.5–5%), whereas in infertile women it is higher (25–40%). Moreover, the rate of infertility has been reported to be six to eight times higher in patients with endometriosis. The monthly pregnancy rate in women in their mid-reproductive years without endometriosis is around 30%, whereas in those with endometriosis it is between only 2% and 10%. This reduced pregnancy rate may even apply to women with minimal endometriosis. There are several treatment options for infertility associated with endometriosis. Women with stage I–II endometriosis may benefit from IUI, while those with stage III–IV endometriosis and tubal factor have the lowest IUI pregnancy rates and thus may benefit less from insemination. IVF is an appropriate treatment for patients who have advanced endometriosis with reduced ovarian reserve, or if tubal function is compromised or if there is male factor infertility or advanced maternal age, and/or other treatments have failed. There is no evidence that surgical treatment of endometriosis improves ovarian function or enhances the possibility of successful IVF.\nAccess this chapter\nTax calculation will be finalised at checkout\nPurchases are for personal use only\nSimilar content being viewed by others\nReferences\nOzkan S, Murk W, Arici A. Endometriosis and infertility: epidemiology and evidence-based treatments. Ann N Y Acad Sci. 2008;1127:92–100.\nHudelist G, Fritzer N, Thomas A, Niehues C, Oppelt P, Haas D, et al. Diagnostic delay for endometriosis in Austria and Germany: causes and possible consequences. Hum Reprod. 2012;27:3412–6.\nHadfield R, Mardon H, Barlow D, Kennedy S. Delay in the diagnosis of endometriosis: a survey of women from the USA and the UK. Hum Reprod. 1996;11:878–80.\nBallard K, Lowton K, Wright J. What’s the delay? A qualitative study of women’s experiences of reaching a diagnosis of endometriosis. Fertil Steril. 2006;86:1296–301.\nNnoaham KE, Hummelshoj L, Webster P, D’Hooghe T, de Cicco NF, de Cicco NC, et al. Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries. Fertil Steril. 2011;96:366–73.\nArruda MS. Time elapsed from onset of symptoms to diagnosis of endometriosis in a cohort study of Brazilian women. Hum Reprod. 2003;18:756–9.\nZondervan KT, Becker CM, Missmer SA. Endometriosis. N Engl J Med. 2020;382:1244–56.\nGiudice LC. Endometriosis. N Engl J Med. 2010;362:2389–98.\nThe Practice Committee of the American Society for Reproductive Medicine. Endometriosis and infertility. Fertil Steril. 2004;81:1441–6.\nKennedy S. Should a diagnosis of endometriosis be sought in all symptomatic women? Fertil Steril. 2006;86:1312–3.\nde la Fuente JAGV G. Endometriosis and infertility, Gynaecol Forum. 2010;15:8–12.\nGarcia-Velasco JA, Somigliana E. Management of endometriomas in women requiring IVF: to touch or not to touch. Hum Reprod. 2009;24:496–501.\nDunselman GAJJ, Vermeulen N, Becker C, Calhaz-Jorge C, D’Hooghe T, De Bie B, et al. ESHRE guideline: management of women with endometriosis. Hum Reprod. 2014;29:400–12.\nWhen more is not better: 10 “don’ts” in endometriosis management. An ETIC position statement. ETIC Endometriosis Treatment Italian Club. Hum Reprod Open. 2019;3:1–15.\nHughes E, Brown J, Collins JJ, Farquhar C, Fedorkow DM, Vandekerckhove P. Ovulation suppression for endometriosis. Cochrane Database Syst Rev. 2007;3:CD000155.\nGeorgiou EX, Melo P, Baker PE, Sallam HN, Arici A, Garcia-Velasco JA, et al. Long-term GnRH agonist therapy before in vitro fertilisation (IVF) for improving fertility outcomes in women with endometriosis. Cochrane Database Syst Rev. 2019;11:CD013240.\nLeonardi M, Gibbons T, Armour M, Wang R, Glanville E, Hodgson R, et al. When to do surgery and when not to do surgery for endometriosis: a systematic review and meta-analysis. J Minim Invasive Gynecol. 2020;27:390–407.\nDemirol A, Guven S, Baykal C, Gurgan T. Effect of endometrioma cystectomy on IVF outcome: a prospective randomized study. Reprod Biomed Online. 2006;12:639–43.\nGarcia-Velasco JA, Mahutte NG, Corona J, Zúñiga V, Gilés J, Arici A, et al. Removal of endometriomas before in vitro fertilization does not improve fertility outcomes: a matched, case–control study. Fertil Steril. 2004;81:1194–7.\nYap C, Furness S, Farquhar C. Pre and post operative medical therapy for endometriosis surgery. Cochrane Database Syst Rev. 2004;3:CD003678.\nJansen R. Minimal endometriosis and reduced fecundability: prospective evidence from an artificial insemination by donor program. Fertil Steril. 1986;46:141–3.\nToma SK, Stovall DW, Hammond MG. The effect of laparoscopic ablation or danocrine on pregnancy rates in patients with stage I or II endometriosis undergoing donor insemination. Obstet Gynecol. 1992;80:253–6.\nTummon IS, Asher LJ, Martin JSB, Tulandi T. Randomized controlled trial of superovulation and insemination for infertility associated with minimal or mild endometriosis. Fertil Steril. 1997;68:8–12.\nDmowski WP, Pry M, Ding J, Rana N. Cycle-specific and cumulative fecundity in patients with endometriosis who are undergoing controlled ovarian hyperstimulation-intrauterine insemination or in vitro fertilization-embryo transfer. Fertil Steril. 2002;78:750–6.\nStarosta A, Gordon CE, Hornstein MD. Predictive factors for intrauterine insemination outcomes: a review. Fertil Res Pract. 2020;6:23.\nOpøien HK, Fedorcsak P, Omland AK, Abyholm T, Bjercke S, Ertzeid G, et al. In vitro fertilization is a successful treatment in endometriosis-associated infertility. Fertil Steril. 2012;97:912–8.\nSenapati S, Sammel MD, Morse C, Barnhart KT. Impact of endometriosis on in vitro fertilization outcomes: an evaluation of the Society for Assisted Reproductive Technologies Database. Fertil Steril. 2016;106:164–71.\nSimón C, Gutiérrez A, Vidal A, de los Santos MJ, Tarín JJ, Remohí J, et al. Outcome of patients with endometriosis in assisted reproduction: results from in-vitro fertilization and oocyte donation. Hum Reprod. 1994;9:725–9.\nDíaz I, Navarro J, Blasco L, Simón C, Pellicer A, Remohí J, et al. Impact of stage III–IV endometriosis on recipients of sibling oocytes: matched case-control study. Fertil Steril. 2000;74:31–4.\nGarcia-Velasco JA, Fassbender A, Ruiz-Alonso M, Blesa D, Dhooghe T, Simon C, et al. Is endometrial receptivity transcriptomics affected in women with endometriosis? A pilot study. Reprod Biomed Online. 2015;31:647–54.\nHamdan M, Dunselman G, Li TCC, Cheong Y. The impact of endometrioma on IVF/ICSI outcomes: a systematic review and meta-analysis. Hum Reprod Update. 2015;21:809–25.\nLessey BA, Gordts S, Donnez O, Somigliana E, Chapron C, Garcia-Velasco JA, et al. Ovarian endometriosis and infertility: in vitro fertilization (IVF) or surgery as the first approach? Fertil Steril. 2018;110:1218–26.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nEditor information\nEditors and Affiliations\nRights and permissions\nCopyright information\n© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG\nAbout this chapter\nCite this chapter\nKohls, G., Garcia-Velasco, J.A. (2022). Endometriosis in Reproductive Years: ART and Endometriosis. In: Oral, E. (eds) Endometriosis and Adenomyosis. Springer, Cham. https://doi.org/10.1007/978-3-030-97236-3_14\nDownload citation\nDOI: https://doi.org/10.1007/978-3-030-97236-3_14\nPublished:\nPublisher Name: Springer, Cham\nPrint ISBN: 978-3-030-97235-6\nOnline ISBN: 978-3-030-97236-3\neBook Packages: MedicineMedicine (R0)","source_license":"CC0","license_restricted":false}