Endometriosis and subfertility

Abstract

Key content: Medical management of endometriosis is often contraceptive. In contrast, surgical treatment may improve the chance of spontaneous conception. There is conflicting evidence as to whether surgery improves outcomes with assisted conception, and this should be discussed with a specialist in reproductive medicine. Surgery, particularly for ovarian endometriosis, can cause a decreased ovarian reserve and fertility preservation should be considered. There is no standard approach to managing endometriosis in the fertility setting. It is important to take a holistic approach to diagnosis and management of the subfertile couple where endometriosis may be a contributing factor. Learning objectives: To understand the mechanisms by which endometriosis can contribute to subfertility. To understand the importance of a comprehensive assessment of the subfertile couple and the important factors that will inform an individualised management plan. To develop a framework for managing endometriosis in the context of subfertility including fertility preservation.