Commentary on the new 2022 European Society of Human Reproduction and Embryology (ESHRE) endometriosis guidelines

Eun Hee Yu, Jong Kil Joo
Clinical and experimental reproductive medicine · 2022 · vol. 49(4) , pp. 219–224 · doi:10.5653/cerm.2022.05603 · PMID:36482496 · W4310008396
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This commentary reviews significant changes in the 2022 ESHRE endometriosis guidelines, offering a more precise and applicable approach to diagnosis and management compared to previous versions.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-08 ⓘ

This paper is a commentary/review summarizing representative updates in the 2022 ESHRE endometriosis guidelines, focusing on changes in diagnosis and treatment recommendations rather than presenting new original data. It highlights a major diagnostic shift: laparoscopy is no longer the diagnostic gold standard and is mainly reserved for patients with negative imaging and/or when empirical treatment is ineffective, with evidence cited from meta-analyses showing imaging modalities (e.g., transvaginal ultrasound and MRI) having diagnostic accuracy for endometrioma and deep endometriosis comparable to surgical diagnosis; the authors note that the new approach acknowledges limitations of noninvasive diagnosis, especially for superficial disease. For endometriosis-associated pain, the guidelines introduce GnRH antagonists as a second-line option (with limited data described for this application) and withdraw certain older options (e.g., anti-progestogens and danazol), and they also summarize evidence for postoperative hormonal therapy potentially reducing pain/illness recurrence within 12 months. The paper relates to endometriosis and adenomyosis research because it centrally discusses endometriosis guideline updates that inform diagnosis and management across endometriosis phenotypes.

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Abstract

Endometriosis is a prevalent benign illness defined by the presence of endometrial glands and stroma outside of the uterine cavity, primarily on the ovary, pelvic peritoneum, and rectovaginal septum, resulting in a variety of symptoms, including dysmenorrhea and infertility. Traditionally, prolonged medical therapy has been needed in most cases since a conservative approach to surgery has usually been taken, especially in young women. In 2022, new European Society of Human Reproduction and Embryology (ESHRE) guidelines were published that present different directions for diagnosis and treatment from the past. Furthermore, the guidelines for the diagnosis and management of endometriosis are more precise and applicable than in previous editions. Thus, referring to the representative changes in the new guidelines and important updates will be beneficial for the diagnosis and management of endometriosis. This paper provides a brief overview of these developments.

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Condition tags

endometriosisdysmenorrheainfertility

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