Endometriosis

Abstract

Most endometriosis patients have fertility complaints and, in spite of the improvement of assisted reproduction procedures, outcomes remain unsatisfactory. This suggests that there are unknown etiopathogenic influences that adversely affect fertility. Medical treatment with gonadotropin-releasing hormone (GnRH) agonists prior to ART is associated with an increase in pregnancy rates, but clinical therapy alone is considered inefficient for treating endometriosis-associated infertility. Undoubtedly, the best approach must be individualized to each infertile couple, combining improvement of pregnancy rates, reduction of morbidity and following good practice principles. The evaluation must be undertaken in a global manner and the essential factors to be considered are patient’s age, grade and type of endometriosis (ovarian, peritoneal or deep infiltrating) and clinical symptoms of the disease.