How to Protect Fertility Potential in Endometriosis

Abstract

Endometriosis is a chronic condition affecting fertile women with many adverse effects. Subfertility is one of the main issues. The ovarian reserve (OR) gradually decreases due to physical and immunological factors associated with endometriosis. Hence, early and prompt treatment of endometriosis and subfertility caused by endometriosis can improve a woman’s quality of life. The article aims to shed light on the currently available options for fertility-preserving management of endometriosis. Endometriosis-related subfertility should be managed judiciously and individually according to age, parity, the extent of the disease, and the patient’s social aspect. Subfertility management is approached by medical management but sometimes demands a surgical approach. But, surgery is very detrimental to OR. That is why, while managing endometriosis, one should aim to protect fertility potential. To approach fertility protection, suppressive therapy, which halts the disease process and prevents follicular loss due to“OMA,” is an option for adolescents and women who want to postpone pregnancy for a certain period. If one needs surgical intervention for treatment, a modified surgical approach to minimize follicular loss would be preferable to protect the OR. Also, while treating subfertility, the approach should be to reduce the time to live birth to avoid the consequences of the recurrence of the disease. And finally, in adolescent endometriosis and women who need repeated surgery, fertility preservation by tissue freezing might help them for future fertility in the present day.