Endometriosis and Infertility

Holoch KJ, Kristin Holoch, Kristin J Holoch, Bruce A. Lessey, Lessey BA
Clinical Obstetrics and Gynecology · 2010 · vol. 53(2) , pp. 429–438 · doi:10.1097/grf.0b013e3181db7d71 · PMID:20436320 · W2985833654
article OA: closed CC0 ⤵ 199 in-corpus citations
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-07 ⓘ

Endometriosis, affecting up to 10% of reproductive-aged women, is strongly associated with infertility, with surgical treatment showing cost-effectiveness and potential for improved fecundity, while medical management's efficacy is unproven outside IVF.

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This review examines the complex relationship between endometriosis and infertility, noting that up to 50% of women with the condition experience difficulty conceiving. The authors synthesize evidence from fertile versus infertile comparisons, animal models, and in vitro fertilization outcomes to elucidate potential mechanisms, particularly those involving endometrial changes in milder disease forms. While surgical ablation or resection is identified as a cost-effective treatment that may improve cycle fecundity, medical management for infertility remains unproven outside of assisted reproductive technologies. This paper is centrally about endometriosis — specifically its impact on fertility and the comparative efficacy of surgical versus medical interventions.

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Abstract

Endometriosis is an enigmatic disease affecting up to 10% of reproductive-aged women causing pain and infertility. Up to 50% of women with endometriosis are infertile, and agreement about treatment options has been difficult to establish. The association between endometriosis and infertility is derived from comparisons of fertile and infertile women, animal models, donor sperm studies, and in vitro fertilization results. Diagnostic approaches based on endometrial changes associated with endometriosis are also providing insights into possible mechanisms of infertility, especially in women with milder forms of the disease. Treatment of endometriosis, including surgical ablation or resection, is cost-effective and offers the potential for improvement in cycle fecundity. Medical management of endometriosis-associated infertility has not been proven outside of in vitro fertilization.
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Endometriosis and Infertility - KRISTIN J. HOLOCH - BRUCE A. LESSEY Endometriosis is an enigmatic disease affecting up to 10% of reproductive-aged women causing pain and infertility. Up to 50% of women with endometriosis are infertile, and agreement about treatment options has been difficult to establish. The association between endometriosis and infertility is derived from comparisons of fertile and infertile women, animal models, donor sperm studies, and in vitro fertilization results. Diagnostic approaches based on endometrial changes associated with endometriosis are also providing insights into possible mechanisms of infertility, especially in women with milder forms of the disease. Treatment of endometriosis, including surgical ablation or resection, is cost-effective and offers the potential for improvement in cycle fecundity. Medical management of endometriosis-associated infertility has not been proven outside of in vitro fertilization.

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Condition tags

endometriosischronic_pelvic_paininfertility

MeSH descriptors

Endometriosis Endometriosis Infertility, Female Endometriosis Endometriosis Endometriosis Evidence-Based Medicine Female Humans Infertility, Female Infertility, Female Infertility, Female Laparoscopy Pelvic Pain Pelvic Pain Pregnancy Prevalence Reproductive Techniques, Assisted Risk Factors Treatment Outcome

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References (24)

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License: CC0 · commercial use OK