Helping a woman afflicted with endometriosis to conceive

Endometriosis is one of the important known causes of infertility. A cause-and-effect relationship between endometriosis and infertility is yet to be proved. The mechanisms leading to infertility because of endometriosis appear to correlate well with the severity of disease, although the exact mechanism is not well delineated. Local factors in the form of pro-inflammatory substances secreted by endometriotic implants may be responsible for reproductive failure in these women. Taking into consideration various factors causing infertility in women with endometriosis, treatment options include medical management, surgical methods, combined medical and surgical procedures, or assisted reproduction techniques (ARTs). The choice of modality depends upon the stage of disease and patient preference. The baseline factors affecting treatment include age of woman, duration of infertility, ovarian reserve, semen parameters, and prior surgery for endometriosis, presence of endometrioma, tubal factor, and ARTs. Guidelines and literature should be able to guide the choice of treatment options to have a successful outcome.