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
Review OA: closed CC0 ⤵ 13 in-corpus citations
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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

endometriosisinfertility

MeSH descriptors

Endometriosis Infertility, Female Adult Adult Danazol Danazol Danazol Endometriosis Endometriosis Endometriosis Estrogen Antagonists Estrogen Antagonists Estrogen Antagonists Female Female Fertilization in Vitro Fertilization in Vitro Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone

Citation neighborhood (2-hop)

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. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (15)

Cited by (13)

SciLite annotations

chemicals 1
danazol

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License: CC0 · commercial use OK