Debate- is it of value to treat endometriosis prior to IVF?

The identification of ectopic "endometrial-like" tissue was first described by Sampson and Cullen in the 1920's (1).This initial finding fueled research into the complex pathology of endometriosis, in addition to treatment modalities that may be employed to reduce associated symptomatology, including pelvic pain and dysmenorrhea, as well as the suspected detrimental impact on fertility.According to the most recent Center for Disease Control (CDC) report on Assisted Reproductive Technology (ART) statistics, six percent of all women seeking ART have been diagnosed with endometriosis.In total, almost 87, 000 fresh cycles from nondonor oocytes are performed in the United States annually, in addition to over 15, 000 frozen embryo transfers (2).Through the use of simple mathematical computation, the number of patients suffering from endometriosis and seeking in vitro fertilization (IVF) is approximately 6, 120, not to mention those whom have been labeled with the diagnosis of "male factor" or "unexplained infertility" and directed to IVF without completing the laparoscopic evaluation to investigate for a peritoneal factor.Barnhart et al. performed a meta-analysis on twenty-two published studies, ultimately concluding that patients with endometriosis-