Semin Reprod Med 2017; 35(01): 031-037
DOI: 10.1055/s-0036-1597125
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Management of Endometriosis in the Infertile Patient

Edgardo Somigliana
1  Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
2  Department of Obstet-Gynecol, Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
,
Paola Vigano
3  Department of Obstet-Gynecol, San Raffaele Scientific Institute, Milan, Italy
,
Laura Benaglia
2  Department of Obstet-Gynecol, Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
,
Andrea Busnelli
1  Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
2  Department of Obstet-Gynecol, Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
,
Nicola Berlanda
2  Department of Obstet-Gynecol, Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
,
Paolo Vercellini
1  Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
2  Department of Obstet-Gynecol, Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
07 December 2016 (eFirst)

Abstract

The management of endometriosis-related infertility remains debated. However, in recent years, the role of in vitro fertilization (IVF) has progressively grown. Reasons to explain this change include (1) the improvement of the effectiveness and safety of IVF, (2) the raised awareness of the modest effectiveness of surgery, (3) the inherent risks of surgery including in particular the damage to the ovarian reserve when ovarian endometriomas have to be removed, (4) the ineffectiveness of intrauterine insemination and the possible risks of endometriosis progression associated with the use of this technique. However, IVF is not able to overcome all the potential detrimental effects of endometriosis and can actually fail. Future efforts should aim at improving the effectiveness and safety of both surgery and IVF. Fertility preservation techniques may play a role in the future, but data are currently too scanty to support its recommendation.