Endometriosis-Related Infertility: The Role of the Assisted Reproductive Technologies

Eric S Surrey
BioMed research international · 2015 · vol. 2015 , pp. 1–8 · doi:10.1155/2015/482959 · PMID:26240824 · W1581513254
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Assisted reproductive technologies, especially IVF, are the most effective treatment for endometriosis-related infertility, with outcomes comparable to controls unless the disease is advanced, though pre-IVF suppression may help some patients.

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Abstract

The assisted reproductive technologies, particularly in vitro fertilization (IVF), represent the most efficient and successful means of overcoming infertility associated with endometriosis. Although older studies suggest that IVF outcomes are compromised in endometriosis patients, more contemporary reports show no differences compared to controls. The exception may be evidence of poorer outcomes and diminished ovarian response in women with advanced disease, particularly those with significant ovarian involvement or prior ovarian surgery. Prolonged pre-IVF cycle suppressive medical therapy, particularly gonadotropin releasing hormone agonists, appears to improve success rates in a subset of endometriosis patients. However, as of yet, there is no diagnostic marker to specifically identify those who would most benefit from this approach. Pre-IVF cycle surgical resection of nonovarian disease has not been consistently shown to improve outcomes with the possible exception of resection of deeply invasive disease, although the data is limited. Precycle resection of ovarian endometriomas does not have benefit and should only be performed for gynecologic indications. Indeed, there is a large body of evidence to suggest that this procedure may have a deleterious impact on ovarian reserve and response. A dearth of appropriately designed trials makes development of definitive treatment paradigms challenging.

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Condition tags

mesh:D004715endometriosisinfertility

MeSH descriptors

Endometriosis Infertility, Female Infertility, Female Patient Selection Pregnancy Complications Reproductive Techniques, Assisted Clinical Decision-Making Clinical Decision-Making Endometriosis Endometriosis Endometriosis Evidence-Based Medicine Female Humans Infertility, Female Infertility, Female Pregnancy Pregnancy Complications Pregnancy Complications Treatment Outcome

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 (66)

Cited by (38)

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