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Endometriosis and Infertility

  • Erin M. Nesbitt-HawesEmail author
  • William Ledger

Abstract

It seems likely that endometriosis has a negative effect on fertility. This may result from reduced frequency of intercourse due to dyspareunia, from anatomical distortion in more severe cases of endometriosis or from more subtle alterations in the intra-ovarian and tubo-peritoneal environments. Medical treatment of endometriosis can waste time, resulting in loss of fertility due to ageing, and does not seem to improve fertility post-treatment. Surgical intervention holds more promise, but may have negative as well as positive impact on fertility. ART remains the mainstay of management of endometriosis associated infertility but treatment programmes should be individualised and outcomes may be less favourable than seen for age-matched couples with other reasons for need for ART.

Keywords

Endometriosis and infertility Infertility and endometriosis Ovarian microenvironment Treatment of endometriosis Endometriosis treatment for infertility Laparoscopic excision of endometriosis Adenomyosis and infertility 

References

  1. 1.
    Schwartz D, Mayaux MJ. Female fecundity as a function of age: results of artificial insemination in 2193 nulliparous women with azoospermic husbands. N Engl J Med. 1982;306:404–6.CrossRefPubMedGoogle Scholar
  2. 2.
    Rodriguez-Escudero FJ, Neyro JL, Corcostegui B, Benito JA. Does minimal endometriosis reduce fecundity? Fertil Steril. 1988;50:522–4.PubMedGoogle Scholar
  3. 3.
    Vercellini P, Pietropaolo G, De Giorgi O, Daguati R, Pasin R, Crosignani PG. Reproductive performance in infertile women with rectovaginal endometriosis: is surgery worthwhile? Am J Obstet Gynecol. 2006;195:1303–10.CrossRefPubMedGoogle Scholar
  4. 4.
    Committee AP. Endometriosis and infertility. Fertil Steril. 2006;86:S156–60.Google Scholar
  5. 5.
    Bulun SE. Endometriosis. N Engl J Med. 2009;360:268–79.CrossRefPubMedGoogle Scholar
  6. 6.
    Giudice LC. Clinical practice. N Engl J Med. 2010;362:2389–98.CrossRefPubMedCentralPubMedGoogle Scholar
  7. 7.
    Abbott J, Hawe J, Hunter D, Holmes M, Finn P, Garry R. Laparoscopic excision of endometriosis: a randomized, placebo-controlled trial. Fertil Steril. 2004;82:878–84.CrossRefPubMedGoogle Scholar
  8. 8.
    Abbott JA, Hawe J, Clayton RD, Garry R. The effects and effectiveness of laparoscopic excision of endometriosis: a prospective study with 2-5 year follow-up. Hum Reprod. 2003;18:1922–7.CrossRefPubMedGoogle Scholar
  9. 9.
    Sutton CJ, Pooley AS, Ewen SP, Haines P. Follow-up report on a randomized controlled trial of laser laparoscopy in the treatment of pelvic pain associated with minimal to moderate endometriosis. Fertil Steril. 1997;68:1070–4.CrossRefPubMedGoogle Scholar
  10. 10.
    Abuzeid MI, Mitwally MF, Ahmed AI, Formentini E, Ashraf M, Abuzeid OM, et al. The prevalence of fimbrial pathology in patients with early stages of endometriosis. J Minim Invasive Gynecol. 2007;14:49–53.CrossRefPubMedGoogle Scholar
  11. 11.
    Lyons RA, Djahanbakhch O, Saridogan E, Naftalin AA, Mahmood T, Weekes A, et al. Peritoneal fluid, endometriosis, and ciliary beat frequency in the human fallopian tube. Lancet. 2002;360:1221–2.CrossRefPubMedGoogle Scholar
  12. 12.
    Piva M, Horowitz GM, Sharpe-Timms KL. Interleukin-6 differentially stimulates haptoglobin production by peritoneal and endometriotic cells in vitro: a model for endometrial-peritoneal interaction in endometriosis. J Clin Endocrinol Metab. 2001;86:2553–61.PubMedGoogle Scholar
  13. 13.
    Muscato JJ, Haney AF, Weinberg JB. Sperm phagocytosis by human peritoneal macrophages: a possible cause of infertility in endometriosis. Obstet Gynecol Surv. 1983;38:177–8.CrossRefGoogle Scholar
  14. 14.
    Shifren JL, Tseng JF, Zaloudek CJ, Ryan IP, Meng YG, Ferrara N, et al. Ovarian steroid regulation of vascular endothelial growth factor in the human endometrium: implications for angiogenesis during the menstrual cycle and in the pathogenesis of endometriosis. J Clin Endocrinol Metab. 1996;81:3112–8.PubMedGoogle Scholar
  15. 15.
    Sharma RK, Wang Y, Falcone T, Goldberg J, Agarwal A. Effect of peritoneal fluid from endometriosis patients on sperm motion characteristics and acrosome reaction. Int J Fertil Womens Med. 1999;44:31–7.PubMedGoogle Scholar
  16. 16.
    Reeve L, Lashen H, Pacey AA. Endometriosis affects sperm-endosalpingeal interactions. Hum Reprod. 2005;20:448–51.CrossRefPubMedGoogle Scholar
  17. 17.
    Hwu Y-M, Wu FS-Y, Li S-H, Sun F-J, Lin M-H, Lee RK-K. The impact of endometrioma and laparoscopic cystectomy on serum anti-Mullerian hormone levels. Reprod Biol Endocrinol. 2011;9:80.CrossRefPubMedCentralPubMedGoogle Scholar
  18. 18.
    Hughes E, Brown J, Collins JJ, Farquhar C, Fedorkow DM, Vandekerckhove P. Ovulation suppression for endometriosis. Cochrane Database Syst Rev. 2007;(3):CD000155.Google Scholar
  19. 19.
    Lv D, Song H, Li Y, Clarke J, Shi G. Pentoxifylline versus medical therapies for subfertile women with endometriosis. Cochrane Database Syst Rev. 2009;(3):CD007677.Google Scholar
  20. 20.
    Barnhart K, Dunsmoor-Su R, Coutifaris C. Effect of endometriosis on in vitro fertilization. Fertil Steril. 2002;77:1148–55.CrossRefPubMedGoogle Scholar
  21. 21.
    Opoien HK, Fedorcsak P, Omland AK, Abyholm T, Bjercke S, Ertzeid G, et al. Invitro fertilization is a successful treatment in endometriosis-associated infertility. Fertil Steril. 2012;97:912–8.CrossRefPubMedGoogle Scholar
  22. 22.
    Guzick DS, Silliman NP, Adamson GD, Buttram Jr VC, Canis M, Malinak LR, et al. Prediction of pregnancy in infertile women based on the American Society for Reproductive Medicine’s revised classification of endometriosis. Fertil Steril. 1997;67:822–9.CrossRefPubMedGoogle Scholar
  23. 23.
    Canis M, Donnez JG, Guzick DS, Halme JK. Revised American Society for Reproductive Medicine classification of endometriosis: 1996. Fertil Steril. 1997;67:817–21.CrossRefGoogle Scholar
  24. 24.
    Marcoux S, Maheux R, Berube S. Laparoscopic surgery in infertile women with minimal or mild endometriosis. Canadian Collaborative Group on Endometriosis. N Engl J Med. 1997;337:217–22.CrossRefPubMedGoogle Scholar
  25. 25.
    Parazzini F. Ablation of lesions or no treatment in minimal-mild endometriosis in infertile women: a randomized trial. Gruppo Italiano per lo Studio dell’Endometriosi. Hum Reprod. 1999;14:1332–4.CrossRefPubMedGoogle Scholar
  26. 26.
    Jacobson TZ, Duffy JM, Barlow D, Farquhar C, Koninckx PR, Olive D. Laparoscopic surgery for subfertility associated with endometriosis. Cochrane Database Syst Rev. 2010;(1):CD001398.Google Scholar
  27. 27.
    Darai E, Lesieur B, Dubernard G, Rouzier R, Bazot M, Ballester M. Fertility after colorectal resection for endometriosis: results of a prospective study comparing laparoscopy with open surgery. Fertil Steril. 2011;95:1903–8.CrossRefPubMedGoogle Scholar
  28. 28.
    Lyons SD, Chew SS, Thomson AJ, Lenart M, Camaris C, Vancaillie TG, et al. Clinical and quality-of-life outcomes after fertility-sparing laparoscopic surgery with bowel resection for severe endometriosis. J Minim Invasive Gynecol. 2006;13:436–41.CrossRefPubMedGoogle Scholar
  29. 29.
    Ferrero S, Anserini P, Abbamonte LH, Ragni N, Camerini G, Remorgida V. Fertility after bowel resection for endometriosis. Fertil Steril. 2009;92:41–6.CrossRefPubMedGoogle Scholar
  30. 30.
    Stepniewska A, Pomini P, Bruni F, Mereu L, Ruffo G, Ceccaroni M, et al. Laparoscopic treatment of bowel endometriosis in infertile women. Hum Reprod. 2009;24:1619–25.CrossRefPubMedGoogle Scholar
  31. 31.
    Pandis GK, Saridogan E, Windsor ACJ, Gulumser C, Cohen CRG, Cutner AS. Short-term outcome of fertility-sparing laparoscopic excision of deeply infiltrating pelvic endometriosis performed in a tertiary referral center. Fertil Steril. 2010;93:39–45.CrossRefPubMedGoogle Scholar
  32. 32.
    Possover M, Diebolder H, Plaul K, Schneider A. Laparascopically assisted vaginal resection of rectovaginal endometriosis. Obstet Gynecol. 2000;96:304–7.CrossRefPubMedGoogle Scholar
  33. 33.
    Redwine DB, Wright JT. Laparoscopic treatment of complete obliteration of the cul-de-sac associated with endometriosis: long-term follow-up of en bloc resection. Fertil Steril. 2001;76:358–65.CrossRefPubMedGoogle Scholar
  34. 34.
    Fedele L, Bianchi S, Zanconato G, Raffaelli R, Berlanda N. Is rectovaginal endometriosis a progressive disease? Am J Obstet Gynecol. 2004;191:1539–42.CrossRefPubMedGoogle Scholar
  35. 35.
    Suginami H, Tokushige M, Taniguchi F, Kitaoka Y. Complete removal of endometriosis improves fecundity. Gynecol Obstet Invest. 2002;53 Suppl 1:12–8.CrossRefPubMedGoogle Scholar
  36. 36.
    Opøien HK, Fedorcsak P, Åbyholm T, Tanbo T. Complete surgical removal of minimal and mild endometriosis improves outcome of subsequent IVF/ICSI treatment. Reprod Biomed Online. 2011;23(3):389–95.CrossRefPubMedGoogle Scholar
  37. 37.
    Darai E, Carbonnel M, Dubernard G, Lavoue V, Coutant C, Bazot M, et al. Determinant factors of fertility outcomes after laparoscopic colorectal resection for endometriosis. Eur J Obstet Gynecol Reprod Biol. 2010;149:210–4.CrossRefPubMedGoogle Scholar
  38. 38.
    Barrier BF, Malinowski MJ, Dick Jr EJ, Hubbard GB, Bates GW. Adenomyosis in the baboon is associated with primary infertility. Fertil Steril. 2004;82 Suppl 3:1091–4.CrossRefPubMedGoogle Scholar
  39. 39.
    Devlieger R, D’Hooghe T, Timmerman D. Uterine adenomyosis in the infertility clinic. Hum Reprod Update. 2003;9:139–47.CrossRefPubMedGoogle Scholar
  40. 40.
    Kissler S, Hamscho N, Zangos S, Wiegratz I, Schlichter S, Menzel C, et al. Uterotubal transport disorder in adenomyosis and endometriosis–a cause for infertility. BJOG. 2006;113:902–8.CrossRefPubMedGoogle Scholar
  41. 41.
    Maubon A, Faury A, Kapella M, Pouquet M, Piver P. Uterine junctional zone at magnetic resonance imaging: a predictor of in vitro fertilization implantation failure. J Obstet Gynaecol Res. 2010;36:611–8.CrossRefPubMedGoogle Scholar
  42. 42.
    Larsen SB, Lundorf E, Forman A, Dueholm M. Adenomyosis and junctional zone changes in patients with endometriosis. Eur J Obstet Gynecol Reprod Biol. 2011;157:206–11.CrossRefPubMedGoogle Scholar
  43. 43.
    Kunz G, Beil D, Huppert P, Noe M, Kissler S, Leyendecker G. Adenomyosis in endometriosis–prevalence and impact on fertility. Evidence from magnetic resonance imaging. Hum Reprod. 2005;20:2309–16.CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag London 2015

Authors and Affiliations

  1. 1.Department of GynecologyRoyal Hospital for WomenSydneyAustralia
  2. 2.Department of Obstetrics and GynaecologyUniversity of New South Wales, Royal Hospital for WomenSydneyAustralia

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