Choice of controlled ovarian stimulation protocols for women with endometriosis-related infertility

Endometriosis (EMS) is one of the important factors of female infertility. The possible causes of infertility include the abnormal pelvic anatomy, the decreased ovarian function and imbalance of immune function. The in vitro fertilization-embryo transfer (IVF-ET) is an effective method for EMS associated with infertility. Gonadotropin-releasing hormone agonists (GnRH-a) prolonged protocol is regarded as the most common treatment for patients with EMS-related infertility. However, long time pituitary suppression may lead to increase of total dosage of Gn used and the risk of poor ovarian response. How to consider the infertility factors of patients with EMS comprehensively and choose personalized GnRH-a protocols for different situations is a clinical challenge. In this review, we summarized the clinical outcomes of different pituitary down regulation protocols in women with EMS-related infertility undergoing IVF-ET and set up the individualized treatment strategy. Key words: Endometriosis; Fertilization in vitro; Embryo transfer; Controlled ovarian stimulation; Clinical outcome