Endometriosis e infertilidad

O. Emilio Fernández, V. Jaime Albornoz
In: Revista Médica Clínica Las Condes · 2010 · vol. 21(3) , pp. 403–408 · doi:10.1016/s0716-8640(10)70551-4 · W2078160612
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This review discusses how endometriosis, presenting in various forms, impacts fertility through anatomical distortion or peritoneal inflammation, with surgical resection being the primary treatment.

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Abstract

Este artículo revisa la evidencia reciente relacionada con el impacto de la endometriosis sobre la fertilidad. La endometriosis se presenta durante la vida reproductiva y es diagnosticada frecuentemente en mujeres en estudio de infertilidad. Tiene múltiples formas de presentación: peritoneal, infiltración profunda, ovárica y/o nódulo rectovaginal. En las etapas avanzadas la infertilidad se explica por la distorsión anatómica de los órganos reproductivos, y en las etapas iniciales, sin distorsión anatómica, se debería a la presencia una de reacción inflamatoria peritoneal, que compromete eventos reproductivos claves como el desarrollo folicular, la ovulación, el desarrollo embrionario y la implantación. El tratamiento de la endometriosis es quirúrgico y consiste en la resección tumoral máxima que permite restablecer la fecundidad natural. Tratamientos complementarios como IO, IIU e IVF, resultan apropiados cuando la cirugía no logra recuperar la fertilidad, en estadios avanzados y/o frente a la presencia de otros factores asociados de infertilidad. This article reviews the current evidence on the impact of endometriosis on fertility. Endometriosis affects women during their reproductive years, and is frequently diagnosed during the infertility work-up. Endometriosis has multiple forms of presentation including: peritoneal, deep-infiltrating, ovarian and/or rectovaginal nodule. In advanced stages, Infertility is explained by the anatomical distortion of the reproductive organs and in early stages, without distortion, the peritoneal inflammatory reaction, might compromise key reproductive events like follicular development, ovulation, embryo development and implantation. Surgery is the apropriate treatment for endometriosis, and consist in the maximum resection of the endometriotic tissue. Complementary treatments like OI, IUI and IVF, are appropriate when fertility is not restored by surgery, in advanced stages of the disease and in the presence of other infertility factors.

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endometriosisinfertility

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