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Endometriosis and Infertility

  • Chapter
Reproductive Surgery in Assisted Conception

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.

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References

  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.

    Article  CAS  PubMed  Google Scholar 

  2. Rodriguez-Escudero FJ, Neyro JL, Corcostegui B, Benito JA. Does minimal endometriosis reduce fecundity? Fertil Steril. 1988;50:522–4.

    CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  4. Committee AP. Endometriosis and infertility. Fertil Steril. 2006;86:S156–60.

    Google Scholar 

  5. Bulun SE. Endometriosis. N Engl J Med. 2009;360:268–79.

    Article  CAS  PubMed  Google Scholar 

  6. Giudice LC. Clinical practice. N Engl J Med. 2010;362:2389–98.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    CAS  PubMed  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    CAS  PubMed  Google Scholar 

  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.

    CAS  PubMed  Google Scholar 

  16. Reeve L, Lashen H, Pacey AA. Endometriosis affects sperm-endosalpingeal interactions. Hum Reprod. 2005;20:448–51.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  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. 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. Barnhart K, Dunsmoor-Su R, Coutifaris C. Effect of endometriosis on in vitro fertilization. Fertil Steril. 2002;77:1148–55.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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. 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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  32. Possover M, Diebolder H, Plaul K, Schneider A. Laparascopically assisted vaginal resection of rectovaginal endometriosis. Obstet Gynecol. 2000;96:304–7.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  35. Suginami H, Tokushige M, Taniguchi F, Kitaoka Y. Complete removal of endometriosis improves fecundity. Gynecol Obstet Invest. 2002;53 Suppl 1:12–8.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  39. Devlieger R, D’Hooghe T, Timmerman D. Uterine adenomyosis in the infertility clinic. Hum Reprod Update. 2003;9:139–47.

    Article  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Gynecology, Royal Hospital for Women, Sydney, Australia

    Erin M. Nesbitt-Hawes B Med(Hons), MRANZCOG

  2. Department of Obstetrics and Gynaecology, University of New South Wales, Royal Hospital for Women, Sydney, Australia

    William Ledger DPhil, FRCOG, FRANZCOG, CREI

Authors
  1. Erin M. Nesbitt-Hawes B Med(Hons), MRANZCOG
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  2. William Ledger DPhil, FRCOG, FRANZCOG, CREI
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Corresponding author

Correspondence to Erin M. Nesbitt-Hawes B Med(Hons), MRANZCOG .

Editor information

Editors and Affiliations

  1. Reproductive Medicine and Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom

    Mostafa Metwally

  2. Obstetrics and Gynaecology, Chinese University of Hong Kong, Hong Kong, China

    Tin-Chiu Li

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© 2015 Springer-Verlag London

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Nesbitt-Hawes, E.M., Ledger, W. (2015). Endometriosis and Infertility. In: Metwally, M., Li, TC. (eds) Reproductive Surgery in Assisted Conception. Springer, London. https://doi.org/10.1007/978-1-4471-4953-8_3

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  • DOI: https://doi.org/10.1007/978-1-4471-4953-8_3

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-4952-1

  • Online ISBN: 978-1-4471-4953-8

  • eBook Packages: MedicineMedicine (R0)

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