Endometriosis and infertility: an integrated approach

William J. Ledger, W L Ledger
International Journal of Gynecology & Obstetrics · 1999 · vol. 64(S1) , pp. 33–40 · doi:10.1016/s0020-7292(98)00240-9 · PMID:10096463 · W2029795891
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⚙ AI-generated summary by claude@2026-06, 2026-06-06 ⓘ

Laparoscopy is the preferred investigation for endometriosis-associated infertility, with surgical ablation improving fertility in minimal/mild disease and IVF with prolonged pituitary down-regulation offering the best hope for moderate/severe disease.

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Abstract

OBJECTIVE: To define an integrated approach to endometriosis-associated infertility. METHODS: Review of published literature with grading of evidence by quality. RESULTS: Laparoscopy remains the investigation of choice in cases of endometriosis-associated infertility and allows the possibility of surgical ablation at diagnosis. This improves fertility in minimal/mild disease, whereas danazol therapy has no benefit. Both in vitro fertilization (IVF) and superovulation with intrauterine insemination improve fertility in mild/minimal disease. Neither surgery nor medical treatment have been shown to improve fertility in moderate/severe disease. IVF with prolonged pituitary down-regulation produced by long-acting gonadotropin-releasing hormone agonists after surgical debulking offers the best hope in such cases. CONCLUSIONS: Endometriosis-related infertility should be treated as rapidly as possible with thorough investigation and the minimum delay between diagnosis and therapy.

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Condition tags

mesh:D004715endometriosisinfertility

MeSH descriptors

Endometriosis Infertility, Female Adult Danazol Danazol Endometriosis Endometriosis Estrogen Antagonists Estrogen Antagonists Female Fertilization in Vitro Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone Gynecologic Surgical Procedures Humans Infertility, Female Infertility, Female Laparoscopy

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (15)

Cited by (13)

SciLite annotations

chemicals 1
danazol

Source provenance

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