Endometriosis-Associated Infertility: An Analysis of Treatment Strategies and Clinical Outcomes

Background: Endometriosis is a chronic estrogen-dependent disorder commonly affecting women of reproductive age and is strongly associated with infertility. Management remains challenging due to its multifactorial pathophysiology and variable response to treatment. Aim: To evaluate clinical characteristics, treatment modalities, and reproductive outcomes in women with endometriosis-associated infertility. Methodology: This hospital-based prospective observational study included 90 infertile women aged 20–40 years with confirmed endometriosis. Patients received individualized management in the form of surgical, medical, combined therapy, or assisted reproductive techniques (ART). Clinical and reproductive outcomes were assessed during follow-up. Results: Most participants were aged 26–35 years and had primary infertility. Moderate to severe disease (rASRM Stages III–IV) predominated. Combined surgery and medical therapy were the most common treatment approach (42.2%). Overall, 48.9% of women achieved pregnancy, with 28.9% conceiving spontaneously and 20% through ART, while 51.1% did not conceive. Conclusion: Nearly half of women with endometriosis-associated infertility achieved pregnancy following treatment. Multimodal, individualized management strategies, including surgery and ART, play a crucial role in optimizing reproductive outcomes.