Endometriosis in Reproductive Years: ART and Endometriosis

Endometriosis 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. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

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(eds) Endometriosis and Adenomyosis. Springer, Cham. https://doi.org/10.1007/978-3-030-97236-3_14 Download citation DOI: https://doi.org/10.1007/978-3-030-97236-3_14 Published: Publisher Name: Springer, Cham Print ISBN: 978-3-030-97235-6 Online ISBN: 978-3-030-97236-3 eBook Packages: MedicineMedicine (R0)