Endometriosis in Reproductive Years: Fertility

The prevalence of endometriosis was found to be 30–50% in infertile women compared to up to 10% in women of reproductive age, suggesting a link between endometriosis and infertility. The causal mechanisms of the impact of endometriosis on fertility are still entirely clear; however, pelvic adhesions in severe endometriosis leading to tubal occlusions, decreased oocyte and embryo quality, altered endometrium function, inflammatory changes in the peritoneal fluid, and hormonal changes may contribute to infertility. The beneficial impact of endometriosis surgery on women seeking spontaneous conception is evident for minimal/milder forms, but it is more difficult to evaluate in moderate/severe cases. Therefore, other factors such as the presence of pain may influence the decision process for surgery. Prior to considering surgery or first-line fertility treatment, a multidisciplinary assessment by specialists in both reproductive medicine and as surgery will aid the patient’s decision-making process. After surgery, the Endometriosis Fertility Index (EFI) should be used to guide future fertility management, such as the need for direct ART or not. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

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Springer, Cham. https://doi.org/10.1007/978-3-030-97236-3_13 Download citation DOI: https://doi.org/10.1007/978-3-030-97236-3_13 Published: Publisher Name: Springer, Cham Print ISBN: 978-3-030-97235-6 Online ISBN: 978-3-030-97236-3 eBook Packages: MedicineMedicine (R0)