Endometriosis and Assisted Reproductive Technology: A Review Article

Background: Endometriosis is a chronic debilitating condition which affects 6-10% of women mostly in at the peak of their reproductive age group. One of the manifestations of this incurable condition is infertility. Up to half of the women with endometriosis will be infertile. One of the means of treating endometriosis related infertility is by using assisted reproductive technology. Objective: To review the literature, share information and our experience on this poorly understood disease especially as it concerns endometriosis and assisted reproductive technology. Method: A review of the literature and our experience in managing infertile women with endometriosis was done and relevant information to the topic retrieved and reported. Setting: Nordica Fertility Centre Lagos. A private assisted conception and endoscopy centre located in Lagos, Nigeria. Results: There are a variety of protocols advocated for assisted reproduction in infertile women with endometriosis. The long protocol with the prolonged down regulation appears to be the preferred method in women with good ovarian reserve as it results in better metaphase II eggs and embryos. Presence of endometrioma does not affect the outcome of IVF and so surgery must be indicated. Risk of disease progression is low. There also no proof that IVF influences risk of cancer of the ovary in women with endometriosis undergoing controlled ovarian hyperstimulation. Conclusion: ART using the long protocol is an effective means of treating infertility in women with endometriosis. It does not increase the risk of disease progression or cancer of the ovary.