Endometriosis and infertility

Abstract

It seems likely that endometriosis has a negative effect on fertility. This may result from reduced frequency of intercourse due to dyspareunia, from anatomical distortion in more severe cases of endometriosis or from more subtle alterations in the intra-ovarian and tubo-peritoneal environments. Medical treatment of endometriosis can waste time, resulting in loss of fertility due to ageing, and does not seem to improve fertility post-treatment. Surgical intervention holds more promise, but may have negative as well as positive impact on fertility. ART remains the mainstay of management of endometriosis associated infertility but treatment programmes should be individualised and outcomes may be less favourable than seen for age-matched couples with other reasons for need for ART.