Endometriosis and Infertility

In: Reproductive Surgery in Assisted Conception · 2015 · pp. 29–35 · doi:10.1007/978-1-4471-4953-8_3 · W2130253675
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Endometriosis negatively impacts fertility through dyspareunia, anatomical distortion, or environmental alterations, with surgery and ART showing variable success.

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This chapter examines how endometriosis affects fertility, including proposed mechanisms such as reduced intercourse from dyspareunia, anatomical distortion in more severe disease, and subtle changes in the intra-ovarian and tubo-peritoneal environments, drawing on evidence across clinical and basic research. It reports that medical treatment may delay conception and thus reduce fertility through aging and that post-treatment fertility improvement is not evident, while surgical intervention may have both positive and negative effects. It also states that assisted reproductive technologies remain the mainstay for endometriosis-associated infertility, with outcomes that may be less favorable than those for age-matched couples using ART for other reasons, and it acknowledges limitations in comparative effectiveness and generalizability across approaches. This paper is centrally about endometriosis — it reviews mechanisms and fertility outcomes, including medical, surgical, and ART management in endometriosis-associated infertility.

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Abstract

It seems likely that endometriosis has a negative effect on fertility. This may result from reduced frequency of intercourse due to dyspareunia, from anatomical distortion in more severe cases of endometriosis or from more subtle alterations in the intra-ovarian and tubo-peritoneal environments. Medical treatment of endometriosis can waste time, resulting in loss of fertility due to ageing, and does not seem to improve fertility post-treatment. Surgical intervention holds more promise, but may have negative as well as positive impact on fertility. ART remains the mainstay of management of endometriosis associated infertility but treatment programmes should be individualised and outcomes may be less favourable than seen for age-matched couples with other reasons for need for ART. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

References

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Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations Rights and permissions Copyright information © 2015 Springer-Verlag London About this chapter Cite this chapter Nesbitt-Hawes, E.M., Ledger, W. (2015). Endometriosis and Infertility. In: Metwally, M., Li, TC. (eds) Reproductive Surgery in Assisted Conception. Springer, London. https://doi.org/10.1007/978-1-4471-4953-8_3 Download citation DOI: https://doi.org/10.1007/978-1-4471-4953-8_3 Publisher Name: Springer, London Print ISBN: 978-1-4471-4952-1 Online ISBN: 978-1-4471-4953-8 eBook Packages: MedicineMedicine (R0)

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