Infertility

The link between endometriosis and infertility is not surprising as it is about three-fold more often seen in women presenting with subfertility than in the general population, and women with endometriosis have a two-fold increased risk of subfertility. It is likely, therefore, that a causal link exists between the two. This chapter will address the pathogenesis of endometriosis-associated infertility and the mechanisms that have been proposed and might explain this link. It will also outline the surgical staging of endometriosis and its relevance, together with other factors, in predicting a percentage chance of natural conception over a three-year period. The chapter will also review management options for women with endometriosis in a fertility setting with view to achieving a pregnancy. Particular attention is drawn to the presence or absence of evidence in support of benefits or risks of such interventions on the improvement of symptoms and/or improving the likelihood of achieving a pregnancy. The authors will also address the potential benefits of fertility preservation strategies (egg or embryo freezing) in women with endometriosis at an early stage and prior to surgical interventions.