Endometriosis and fertility.

Skorupskaite, K.; Bhandari H.M.

Endometriosis and fertility.

All Authors

Skorupskaite, K.

Bhandari H.M.

LTHT Author

Skorupskaite, Karolina
Bhandari, Harish

LTHT Department

Centre for Reproductive Medicine

Publication Date

2024

Item Type

Review

Abstract

Endometriosis is a chronic inflammatory condition of reproductive age which can lead to infertility and chronic pelvic pain. Endometriosis-associated infertility is not well understood and it appears to be multi-factorial; mechanical, inflammatory, hormonal, genetic and environmental processes can disturb each step of the normal reproductive physiology; folliculogenesis, ovulation, sperm function, gamete transport, fertilization and implantation. Medical management has limited role for patients with endometriosis wishing to conceive. On-going pregnancy rate for infertile patients with milder disease is improved by surgery. Surgical management of severe disease and endometrioma for infertility needs careful consideration as the evidence for benefits of improved reproductive outcome lacks consistency but is associated with increased surgical risks and can lead to iatrogenic decline in ovarian reserve and fertility. Endometriosis-associated infertility is a recognized indication for assisted reproductive technology procedures. Fertility preservation may be appropriate for those with risk factors for premature endometriosis-related fertility loss.