Treatment of Endometriosis-Associated Infertility

G D Adamson, G. David Adamson
Seminars in reproductive endocrinology · 1997 · vol. 15(03) , pp. 263–271 · doi:10.1055/s-2008-1068756 · PMID:9383835 · W2089237837
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

Laparoscopic ablation/resection of lesions is the most successful treatment for endometriosis-associated infertility, with hormonal suppression, ovarian stimulation, and IVF indicated in specific circumstances.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-08 ⓘ

The paper reviews evidence on treatment options for endometriosis-associated infertility, noting that treatment choice has been controversial due to limited data historically. It reports that over the prior decade, improved study designs supported laparoscopic ablation and/or resection of lesions as the most successful approaches for minimal/mild and moderate/severe/extensive disease, with laparotomy used when necessary. It states that observation alone can be appropriate for young women with minimal/mild disease, hormonal suppression has no clear role except possibly before IVF or GIFT in severe/extensive disease, and that clomiphene or gonadotropin ovarian stimulation with intrauterine insemination fits minimal/mild disease while IVF or GIFT are often best after other treatment failure or in cases such as advanced age or prolonged or multifactor infertility. This paper is centrally about endometriosis — it focuses specifically on treatment strategies for endometriosis-associated infertility and their reported success across disease severity and patient circumstances.

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Abstract

The choice of treatment options for endometriosis-associated infertility has been both controversial and complex, largely because of lack of data. In the last 10 years, better data from numerous studies with improved design support laparoscopic ablation and/or resection of lesions as the most successful for both minimal/mild and moderate/severe/extensive disease. Laparotomy should be performed when necessary. Observation alone is sometimes indicated in young women with minimal/mild disease. Hormonal suppression has no identifiable role, except perhaps for severe/extensive disease, before IVF or GIFT. Ovarian stimulation with clomiphene or gonadotropins and concomitant intrauterine insemination is indicated for minimal/mild disease. IVF and GIFT are often best for those who have failed other treatments, have advanced age, prolonged infertility, and/or multiple-factor infertility.

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Condition tags

endometriosisinfertility

MeSH descriptors

Endometriosis Infertility, Female Clomiphene Clomiphene Endometriosis Female Fertility Agents, Female Fertility Agents, Female Fertilization in Vitro Fertilization in Vitro Gamete Intrafallopian Transfer Gamete Intrafallopian Transfer Gonadotropins Gonadotropins Humans Infertility, Female Insemination, Artificial Insemination, Artificial Laparoscopy Laparoscopy

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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