{"paper_id":"6f16e18b-23ed-461f-be18-44924dd933cc","body_text":"Abstract\nLaparoscopy is the gold standard for the definitive diagnosis and management of endometriosis. The surgical goal in endometriosis is to remove all visible disease and at the same time conserve as much ovarian tissue as possible. Any endometrioma >4 cm should be excised and sent for histopathology to rule out malignancy.\nExcision or ablation of endometriotic lesions and adhesiolysis improves fertility and increases pregnancy rates of those continuing more than 20 weeks in minimal to mild endometriosis. Surgical clearance of endometriotic disease improves spontaneous pregnancy rates in moderate to severe endometriosis. Surgery in expert hands decreases chances of loss of normal ovarian reserves. IUI or IVF/ICSI improves pregnancy rates if used after cystectomy. Preoperative treatment with GnRH agonist for 3–4 months before IVF/ICSI in patients with endometriosis improves pregnancy rates.\nAccess this chapter\nTax calculation will be finalised at checkout\nPurchases are for personal use only\nSimilar content being viewed by others\nReferences\nEvers JL. The second-look laparoscopy for evaluation of the result of medical treatment of endometriosis should not be performed during ovarian suppression. Fertil Steril. 1987;47(3):502–4.\nDunselman GA, 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(3):400–12.\nJacobson TZ, Barlow DH, Koninckx PR, Olive D, Farquhar C. Laparoscopic surgery for subfertility associated with endometriosis. Cochrane Database Syst Rev. 2002;(4):CD001398.\nLohn FH, Tan AT, Kumar J, Ng SC. Ovarian response after laparoscopic ovarian cystectomy for endometriotic cysts in 132 monitored cycles. Fertil Steril. 1999;72(2):316–21.\nFedele L, Bianchi S, Zanconato G, Berlanda N, Raffaelli R, Fontana E. Laparoscopic excision of recurrent endometriomas: long term outcome and comparison with primary surgery. Fertil Steril. 2006;85(3):694–9.\nYap C, Furness S, Farquhar C. Pre and post operative medical therapy for endometriosis surgery. Cochrane Database Syst Rev. 2004;(3):CD003678.\nBrown J, Farquhar C. Endometriosis: an overview of Cochrane Reviews. Cochrane Database Syst Rev. 2014;3:CD009590.\nSallam HN, Garcia-Velasco JA, Dias S, Arici A. Long-term pituitary down-regulation before in vitro fertilization (IVF) for women with endometriosis. Cochrane Database Syst Rev. 2006;(1)CD004635.\nBenschop L, Farquhar C, van der Poel N, Heineman MJ. Interventions for women with endometrioma prior to assisted reproductive technology. Cochrane Database Syst Rev. 2010;(11)CD008571.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nEditor information\nEditors and Affiliations\nRights and permissions\nCopyright information\n© 2015 Springer India\nAbout this chapter\nCite this chapter\nJha, U.P., Kaur, R., Sharma, N., Agrawal, R., Lal, P. (2015). Endometriosis: Surgical Management and Optimal Ovarian Stimulation Protocol for ART. In: Ghumman, S. (eds) Principles and Practice of Controlled Ovarian Stimulation in ART. Springer, New Delhi. https://doi.org/10.1007/978-81-322-1686-5_28\nDownload citation\nDOI: https://doi.org/10.1007/978-81-322-1686-5_28\nPublisher Name: Springer, New Delhi\nPrint ISBN: 978-81-322-1685-8\nOnline ISBN: 978-81-322-1686-5\neBook Packages: MedicineMedicine (R0)","source_license":"CC0","license_restricted":false}