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Women with advanced endometriosis have a low chance of getting pregnant and are therefore commonly recommended to undergo surgery with the goal of destroying or removing abnormal endometriosis tissue and scars.
However, women with milder forms of endometriosis may not actually be at higher risk of infertility compared to other women.
This issue is very controversial,; it would be difficult to routinely recommend extensive surgery to a women with mild endometriosis.
It is not yet determined whether surgery increases fertility rates in women with mild endometriosis.
It is likely that surgery only provides small benefit, or even no benefit, in this situation.

Unfortunately, none of the medications reviewed above have any impact on infertility in women with endometriosis.
In fact, the medications will actually inhibit a woman's ability to conceive during the time a woman is using them.
Essentially, a woman with endometriosis who is struggling to get pregnant only has 2 choices:

  • ovulation induction
  • assisted reproduction techniques.

Research has shown that ovulation induction with or without intrauterine insemination can increase fertility in women with endometriosis-associated infertility.
Ovulation induction
involves using medications

  • GnRH agonists,
  • follicle-stimulating hormone,
  • luteinizing hormone,
  • clomiphene citrate

with or without intrauterine insemination to increase fertility.
Intrauterine insemination is placement of the fertilized egg directly into the uterus. 

In-vitro fertilization has not yet been supported with researchs in endometriosis.
It may be indicated in women with advanced endometriosis, but may not increase pregnancy rates in women with mild endometriosis.
It is still unclear what the optimal duration of in vitro fertilization therapy in women with endometriosis.

   

 

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