Skip to main content
SpringerLink
Log in

Treatment of Endometriosis in Women Desiring Fertility

  • Invited Mini Review
  • Published:
The Journal of Obstetrics and Gynecology of India Aims and scope Submit manuscript

Abstract

Endometriosis is a common condition affecting a significant proportion of women in their reproductive age. Apart from the impact of endometriosis on the quality of life of these patients, it also can have an impact on the potential of these women to have a family. The options for treating women with endometriosis desiring a family include surgery or assisted reproduction techniques. The choice of treatment will depend on the stage of disease and the characteristics of the couple seeking help. We review here the latest evidence on the management of endometriosis in women desiring fertility and describe our current practice.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Gupta S, Goldberg JM, Aziz N, et al. Pathogenic mechanisms in endometriosis-associated infertility. Fertil Steril. 2008;90:247–57.

    Article  CAS  PubMed  Google Scholar 

  2. Akande VA, Hunt LP, Cahill DJ, et al. Differences in time to natural conception between women with unexplained infertility and infertile women with minor endometriosis. Hum Reprod (Oxford, England). 2004;19:96–103.

    Article  Google Scholar 

  3. De Ziegler D, Borghese B, Chapron C. Endometriosis and infertility: pathophysiology and management. Lancet. 2010;376:730–8.

    Article  PubMed  Google Scholar 

  4. Lyons RA, Saridogan E, Djahanbakhch O. The effect of ovarian follicular fluid and peritoneal fluid on Fallopian tube ciliary beat frequency. Hum Reprod. 2006;21:52–6.

    Article  CAS  PubMed  Google Scholar 

  5. Dunselman GA, Vermeulen N, Becker C, et al. ESHRE guideline: management of women with endometriosis. Hum Reprod (Oxford, England). 2014;29:400–12.

    Article  CAS  Google Scholar 

  6. Hudelist G, English J, Thomas AE, et al. Diagnostic accuracy of transvaginal ultrasound for non-invasive diagnosis of bowel endometriosis: systematic review and meta-analysis. Ultrasound Obstet Gynecol Off J Int Soc Ultrasound Obstet Gynecol. 2011;37:257–63.

    Article  CAS  Google Scholar 

  7. Holland TK, Hoo WL, Mavrelos D, et al. Reproducibility of assessment of severity of pelvic endometriosis using transvaginal ultrasound. Ultrasound Obstet Gynecol Off J Int Soc Ultrasound Obstet Gynecol. 2013;41:210–5.

    Article  CAS  Google Scholar 

  8. Holland TK, Yazbek J, Cutner A, et al. Value of transvaginal ultrasound in assessing severity of pelvic endometriosis. Ultrasound Obstet Gynecol Off J Int Soc Ultrasound Obstet Gynecol. 2010;36:241–8.

    Article  CAS  Google Scholar 

  9. Vercellini P, Fedele L, Aimi G, et al. Reproductive performance, pain recurrence and disease relapse after conservative surgical treatment for endometriosis: the predictive value of the current classification system. Hum Reprod (Oxford, England). 2006;21:2679–85.

    Article  Google Scholar 

  10. Adamson GD, Pasta DJ. Endometriosis fertility index: the new, validated endometriosis staging system. Fertil Steril. 2010;94:1609–15.

    Article  PubMed  Google Scholar 

  11. Jacobson, T. Z., Duffy, J. M., Barlow, D et al. Laparoscopic surgery for subfertility associated with endometriosis. The Cochrane database of systematic reviews CD001398 (2010). doi:10.1002/14651858.CD001398.pub2.

  12. Vercellini P, Somigliana E, Viganò P, et al. Surgery for endometriosis-associated infertility: a pragmatic approach. Hum Reprod (Oxford, England). 2009;24:254–69.

    Article  Google Scholar 

  13. Hughes E, Brown J, Collins JJ, et al. Ovulation suppression for endometriosis for women with subfertility. Cochrane Libr. 2007;. doi:10.1002/14651858.CD000155.

    Google Scholar 

  14. Muzii L, Bianchi A, Bellati F, et al. Histologic analysis of endometriomas: what the surgeon needs to know. Fertil Steril. 2007;87:362366.

    Google Scholar 

  15. Hart, R. J., Hickey, M., Maouris, P et al. Excisional surgery versus ablative surgery for ovarian endometriomata. The Cochrane database of systematic reviews CD004992 (2008). doi:10.1002/14651858.CD004992.pub3.

  16. Muzii L, Di Tucci C, Di Feliciantonio M, et al. The effect of surgery for endometrioma on ovarian reserve evaluated by antral follicle count: a systematic review and meta-analysis. Hum Reprod. 2014;. doi:10.1093/humrep/deu199.

    Google Scholar 

  17. Vercellini P, Pietropaolo G, De Giorgi O, et al. Reproductive performance in infertile women with rectovaginal endometriosis: is surgery worthwhile? Am J Obstet Gynecol. 2006;195:1303–10.

    Article  PubMed  Google Scholar 

  18. Meuleman C, Tomassetti C, D’Hoore A, et al. Surgical treatment of deeply infiltrating endometriosis with colorectal involvement. Hum Reprod Update. 2011;17:311–26.

    Article  PubMed  Google Scholar 

  19. Meuleman C, Tomassetti C, Wolthuis A, et al. Clinical outcome after radical excision of moderate—severe endometriosis with or without bowel resection and reanastomosis: a prospective Cohort study. Ann Surg. 2014;259:522–31. doi:10.1097/SLA.0b013e31828dfc5c.

    Article  PubMed  Google Scholar 

  20. Werbrouck E, Spiessens C, Meuleman C, et al. No difference in cycle pregnancy rate and in cumulative live-birth rate between women with surgically treated minimal to mild endometriosis and women with unexplained infertility after controlled ovarian hyperstimulation and intrauterine insemination. Fertil Steril. 2006;86:566571.

    Article  Google Scholar 

  21. Steures P, van der Steeg JW, Hompes PG, et al. Effectiveness of intrauterine insemination in subfertile couples with an isolated cervical factor: a randomized clinical trial. Fertil Steril. 2007;88:1692–6.

    Article  PubMed  Google Scholar 

  22. Tsoumpou I, Kyrgiou M, Gelbaya T, et al. The effect of surgical treatment for endometrioma on in vitro fertilization outcomes: a systematic review and meta-analysis. Fertil Steril. 2009;92:75–87.

    Article  PubMed  Google Scholar 

  23. Demirol A, Guven S, Baykal C, et al. Effect of endometrioma cystectomy on IVF outcome: a prospective randomized study. Reprod Biomed Online. 2006;12:639–43.

    Article  PubMed  Google Scholar 

  24. Coccia M, Rizzello F, Barone S, et al. Is there a critical endometrioma size associated with reduced ovarian responsiveness in assisted reproduction techniques? Reprod BioMed Online. 2014;. doi:10.1016/j.rbmo.2014.04.019.

    PubMed  Google Scholar 

  25. Opøien H, Fedorcsak P, Byholm T, et al. Complete surgical removal of minimal and mild endometriosis improves outcome of subsequent IVF/ICSI treatment. Reprod Biomed Online. 2011;23:389–95.

    Article  PubMed  Google Scholar 

Download references

Compliance with ethical requirements and Conflict of interest

The manuscript does not contain clinical studies or patient data. Mavrelos D and Saridogan E declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Institute of Women’s Health, University College London, London, UK

    D. Mavrelos (Lecturer)

  2. University College Hospital London , London, UK

    E. Saridogan (Consultant Gynaecologist)

Authors
  1. D. Mavrelos
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. E. Saridogan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to D. Mavrelos.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mavrelos, D., Saridogan, E. Treatment of Endometriosis in Women Desiring Fertility. J Obstet Gynecol India 65, 11–16 (2015). https://doi.org/10.1007/s13224-014-0652-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13224-014-0652-y

Keywords

Search

Navigation