Should we consider integrated approach for endometriosis-associated infertility as gold standard management? Rationale and results from a large cohort analysis

Vesna Šalamun, Ivan Verdenik, Antonio Simone Laganà, Eda Vrtačnik Bokal, Eda Vrtačnik-Bokal
Archives of gynecology and obstetrics · 2017 · vol. 297(3) , pp. 613–621 · doi:10.1007/s00404-017-4633-0 · PMID:29274003 · W2780235849
article OA: closed CC0 ⤵ 18 in-corpus citations
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-07 ⓘ

Comparing surgical and integrated (surgery + IVF) approaches for endometriosis-associated infertility, this study found similar delivery rates but worse neonatal outcomes with the integrated approach.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This retrospective cohort study evaluated reproductive and maternal–fetal outcomes in 277 women with endometriosis-associated infertility, comparing a surgery-only group (laparoscopic surgery) versus an integrated pathway where women who failed to conceive spontaneously after 6–12 months underwent IVF with embryo transfer. Delivery rate did not differ between groups, but the integrated group had lower birth weight and gestational age, with higher rates of preterm birth, small for gestational age, and neonatal intensive care unit admission. For subsequent pregnancies, 92 women conceived again, with a smaller fraction becoming pregnant spontaneously versus more pregnancies occurring after IVF. The study is limited by its retrospective design and by the integrated-group selection based on failure to conceive after surgery. This paper is centrally about endometriosis — it analyzes an integrated surgical-and-IVF management pathway for endometriosis-associated infertility and reports associated maternal–neonatal outcomes.

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Condition tags

endometriosisinfertility

MeSH descriptors

Embryo Transfer Endometriosis Fertilization in Vitro Fertilization in Vitro Gynecologic Surgical Procedures Infertility, Female Ovarian Reserve Adult Birth Weight Cohort Studies Endometriosis Endometriosis Female Gestational Age Gynecologic Surgical Procedures Humans Infertility, Female Infertility, Female Laparoscopy Pregnancy

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