Fertility and endometriosis

Twenty to forty per cent of infertile women have endometriosis associated. After a complete study of the couple, endometriosis treatment or assisted reproduction should be choose as first therapy, since there is no evidence that surgery improves the outcome of fertility treatments. The gold standard surgical treatment for endometriomas is laparoscopic cystectomy, although ultrasound-guided aspiration and sclerosis preserve a greater number of oocytes as new technique. Artificial insemination, especially when associated with ovarian stimulation, improves fertility in women with mild or moderate endometriosis compared with expectant management, despite the negative impact of endometriosis on the effectiveness of treatment. IVF is the most appropriate treatment when the function of the tubes is committed, when there is associated male factor infertility or when other treatments have failed.