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Semin Reprod Med 1997; 15(3): 263-271
DOI: 10.1055/s-2008-1068756
Copyright © 1997 by Thieme Medical Publishers, Inc.

Treatment of Endometriosis-Associated Infertility

G. David Adamson
  • Stanford University School of Medicine, Stanford, California; University of California School of Medicine, San Francisco, California; Fertility Physicians of Northern California, Palo Alto, California.
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Publication History

Publication Date:
15 March 2008 (online)

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Abstract

The choice of treatment options for endometriosis-associated infertility has been both controversial and complex, largely because of lack of data. In the last 10 years, better data from numerous studies with improved design support laparoscopic ablation and/or resection of lesions as the most successful for both minimal/mild and moderate!severe! extensive disease. Laparotomy should be performed when necessary. Observation alone is sometimes indicated in young women with minimal/mild disease. Hormonal suppression has no identifiable role, except perhaps for severe/extensive disease, before IVF or GIFT. Ovarian stimulation with clomiphene or gonadotropins and concomitant intrauterine insemination is indicated for minimal/mild disease. IVF and GIFT are often best for those who have failed other treatments, have advanced age, prolonged infertility, andfor multiple-factor infertility.

Keywords:

Endometriosis - infertility - pregnancy rate - treatment statistics