Endometriosis : A puzzle waiting to be solved

Endometriosis affects about 10% of all women of reproductive age and up to 50% of those with infertility. The aetiology, pathophysiology and natural history of this disease are still poorly understood despite extensive research. The quality of an embryo, that is, its ability to develop and implant normally, is reduced by the presence of endometriosis. There is no role for hormonal drug therapy in the treatment of endometriosis-related infertility. If endometriosis is suspected, a pelvic ultrasound scan is normal and the patient does not wish to conceive, then a trial of drug therapy may be offered as an alternative to laparoscopy. Conservative surgical treatment of endometriosis results in higher pregnancy rates than diagnostic laparoscopy alone. (author abstract)