Endometriosis‐associated infertility: aspects of pathophysiological mechanisms and treatment options

Tanbo T, Tom Tanbo, Peter Fedorcsak, Péter Fedorcsák
Acta obstetricia et gynecologica Scandinavica · 2016 · vol. 96(6) , pp. 659–667 · doi:10.1111/aogs.13082 · PMID:27998009 · W2561275787
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Endometriosis-associated infertility involves anatomical, endocrine, and immunological factors, with surgical treatments being controversial and assisted reproductive technologies like IUI and IVF offering varying success rates depending on disease severity.

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Abstract

Endometriosis is a common condition in women of reproductive age. In addition to pain, endometriosis may also reduce fertility. The causes of infertility in women with endometriosis may range from anatomical distortions due to adhesions and fibrosis to endocrine abnormalities and immunological disturbances. In some cases, the various pathophysiological disturbances seem to interact through mechanisms so far not fully understood. Whether surgery should be offered as a treatment option in endometriosis-associated infertility has become controversial, partly due to its modest or undocumented effect. Medical or hormonal treatment alone has little or no effect and should only be used in conjunction with assisted reproductive technology (ART). Of the various methods of ART, intrauterine insemination, due to its simplicity, can be recommended in women with minimal or mild peritoneal endometriosis, even though insemination may yield a lower success rate than in women without endometriosis. In vitro fertilization (IVF) is an effective treatment option in less-advanced disease stages, and the success rates are similar to the results in other causes of infertility. However, women with more advanced stages of endometriosis have lower success rates with IVF.

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Condition tags

endometriosisinfertility

MeSH descriptors

Endometriosis Infertility, Female Reproductive Techniques, Assisted Endometriosis Endometriosis Endometriosis Female Fertilization in Vitro Humans Infertility, Female Infertility, Female Insemination, Artificial Insemination, Artificial Ovulation Induction Ovulation Induction Pregnancy

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References (73)

Cited by (50)

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