Endometriosis and assisted reproduction technology

Endometriosis is a disease that is historically known to present in many guises. Since 13th century it has been metaphorically regarded as an animalistic womb causing female hysteria. Albeit widely researched, significant controversies that surround the disease remain unsolved, from the clinical presentations, diagnosis, right through to its management strategies. Despite the rapid advancement of technology in modern medicine, the ideal diagnostic and investigative tool of the disease remains elusive, and hence the management of the disease remains a challenge to clinicians. Whilst it is long known that endometriosis is detrimental to fertility, it is unclear if Assisted Reproductive Technology (ART) obliterates that risk. This thesis aims to investigate the impact of different stages and types of endometriosis on ART outcomes, and how various surgical interventions influence the reproductive outcomes. The thesis will also focus on answering two important questions in endometriosis research, that of whether and how endometriosis impacts on 1) the developing oocytes and embryo, and 2) the endometrium. The thesis begins with the introduction of two robust systematic reviews and meta-analyses, which concluded ... (continues)