Endometriosis and infertility

In: Modern Approaches to Endometriosis · 1991 · pp. 113–128 · doi:10.1007/978-94-011-3864-2_7 · W3151912618
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This paper questions the causal relationship between pelvic endometriosis and infertility, considering the increasing diagnosis frequency and possibility of coincidental findings.

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This paper examines whether endometriosis itself is causally related to infertility when there is no obvious mechanical damage, noting that laparoscopy has increasingly identified endometriosis among infertile women and that treatment has been medical or surgical. The authors argue that pelvic endometriosis may be more common than previously thought, raising the possibility that its detection in infertile women could be coincidental rather than causative. A major caveat is that distinguishing correlation from causation is difficult given the limitations of diagnosis and the overlap between endometriosis and other infertility factors, so the causal question remains controversial. This paper is centrally about endometriosis — it specifically discusses endometriosis in the context of infertility and the evidence for or against a causal relationship.

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Abstract

It is axiomatic that before treatment of a disease can be justified it must be shown to confer benefit. Since the introduction of the laparoscope, clinicians have been diagnosing endometriosis in the infertile woman with increasing frequency. It is current practice to treat this either medically or surgically and yet perhaps the most controversial clinical problem with endometriosis is whether, if there is no mechanical damage, it has a causal relationship with infertility. The picture is further obscured by recent evidence that pelvic endometriosis is a more ubiquitous phenomenon than previously realized. It is quite possible that the finding of endometriosis is coincidental to the infertility. Preview Unable to display preview. Download preview PDF. Similar content being viewed by others

References

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Is “microscopic” peritoneal endometriosis invisible? Fertil. Steril., 50, 665–666 Pepperell, R.J. and McBain, J.C. (1985). Unexplained infertility: a review. Br. J. Obstet. Gynaecol., 92, 569–580 Evers, J. (1987). The second look laparoscopy for the evaluation of the results of medical treatment of endometriosis should not be performed during ovarian suppression. Fertil. Steril., 47, 502–504 Editor information Editors and Affiliations Rights and permissions Copyright information © 1991 Springer Science+Business Media Dordrecht About this chapter Cite this chapter Thomas, E.J. (1991). Endometriosis and infertility. In: Thomas, E.J., Rock, J.A. (eds) Modern Approaches to Endometriosis. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-3864-2_7 Download citation DOI: https://doi.org/10.1007/978-94-011-3864-2_7 Publisher Name: Springer, Dordrecht Print ISBN: 978-94-010-5719-6 Online ISBN: 978-94-011-3864-2 eBook Packages: Springer Book Archive

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