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. |