What is the impact of endometriosis on fertility?
Although management of pain may be the more immediate issue, the long term outcome of fertility should not be overlooked. Few studies have examined this. A systematic review of medical treatment for women with infertility and endometriosis did not find evidence of benefit, and it is not recommended for women trying to conceive. A systematic review of laparoscopic treatment of endometriosis in women with subfertility suggested an improvement in pregnancy rate in the 9-12 months after surgery.w31 A second systematic review of laparoscopic excision compared with ablation endometriomata reported a fivefold increase in rate of pregnancy. There is the ongoing concern about ovarian reserve in women who have laparoscopic excision. w28 The other concern is the impact of endometriomata on artificial reproductive techniques.w32 The European Society for Human Reproduction and Embryology (ESHRE) recommends surgery if endometriomata are 4 cm. Aim of study: The objective of this review was to determi
