Endometriosis-associated infertility

Buyalos RP, Richard P. Buyalos, R P Buyalos, Sanjay K. Agarwal, S K Agarwal
Current opinion in obstetrics & gynecology · 2000 · vol. 12(5) , pp. 377–381 · doi:10.1097/00001703-200010000-00006 · PMID:11111879 · W2013195190
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-06 ⓘ

This review examines the association between endometriosis stages and infertility, concluding advanced stages and mechanical disruption cause infertility, while early stages remain controversial, and recommends individualized management with ablative therapy and IVF/ET.

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This review examines the complex relationship between endometriosis and infertility, noting that advanced disease stages cause infertility through mechanical disruption of pelvic anatomy. The authors highlight ongoing controversy regarding whether early-stage endometriosis directly impacts fertility and emphasize that management strategies must be tailored to disease stage, patient age, and duration of infertility. Key findings indicate that ablative therapy during laparoscopy is as effective or superior to expectant or medical approaches, while ovarian suppression with GnRH agonists is generally not warranted except in the context of IVF. Controlled ovarian hyperstimulation combined with intrauterine insemination is identified as an appropriate treatment for women with minimal-to-mild or surgically corrected endometriosis. This paper is centrally about endometriosis — specifically its association with infertility and the corresponding therapeutic interventions.

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Abstract

This review summarizes the recent literature examining the relationship between endometriosis and infertility. It is clear that the advanced stage of the disease and the mechanical disruption of the pelvic anatomy may cause infertility. The link between early stage endometriosis and infertility remains a source of controversy. Management plans must be individualized contingent upon the stage of disease, the age of the patient and the duration of infertility. The preponderance of data suggests that ablative therapy at the time of laparoscopy is as good as, or superior to expectant or medical therapy. With the exception of IVF/ET, ovarian suppression with GnRH agonists is not warranted in endometriosis-associated infertility. Controlled ovarian hyperstimulation with IUI is appropriate therapy in women with minimal-to-mild and surgically corrected endometriosis.
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Endometriosis-associated infertility - Richard P Buyalos - Sanjay K Agarwal This review summarizes the recent literature examining the relationship between endometriosis and infertility. It is clear that the advanced stage of the disease and the mechanical disruption of the pelvic anatomy may cause infertility. The link between early stage endometriosis and infertility remains a source of controversy. Management plans must be individualized contingent upon the stage of disease, the age of the patient and the duration of infertility. The preponderance of data suggests that ablative therapy at the time of laparoscopy is as good as, or superior to expectant or medical therapy. With the exception of IVF/ET, ovarian suppression with GnRH agonists is not warranted in endometriosis-associated infertility. Controlled ovarian hyperstimulation with IUI is appropriate therapy in women with minimal-to-mild and surgically corrected endometriosis.

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Condition tags

endometriosisinfertility

MeSH descriptors

Endometriosis Infertility, Female Endometriosis Endometriosis Endometriosis Female Humans Infertility, Female Infertility, Female Ovulation Induction Pregnancy

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.

References (36)

Cited by (50)

Source provenance

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License: CC0 · commercial use OK