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Human Reproduction, Vol. 17, No. 5, 1135-1140, May 2002
© 2002 European Society of Human Reproduction and Embryology

What is the optimal medical management of infertility and minor endometriosis?

Analysis and future prospects

D.J. Cahill

Centre for Reproductive Medicine, University of Bristol, Division of Obstetrics and Gynaecology, St Michael's Hospital, Southwell Street, Bristol BS2 8EG, UK. E-mail: d.j.cahill{at}bris.ac.uk

By asking the question `What is the optimal medical management of infertility and minor endometriosis?', it is assumed that endometriosis has a detrimental effect on fertility. The published data suggest that oocyte dysfunction may contribute to infertility associated with endometriosis. This is expressed as a reduction in fertilization and implantation rates; implantation rates to a lesser extent, though still significant. Other evidence for oocyte dysfunction exists, not all of which is consistent. Suppression of ovulation and menstruation to treat endometriosis-associated infertility is not effective. However, ovulation induction, perhaps with intrauterine insemination, does result in pregnancy rates higher than in control cycles, while stimulated IVF success rates are equivalent to those of other diagnostic groups. For the future, angiogenesis is critical to the support of endometriotic deposits and targeted therapies are promised; their role in improving fertility has not yet been explored.

Key words: endometriosis/infertility/medical treatment


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J. H. Check
What role does decreased ovarian reserve play in the aetiology of infertility related to endometriosis?
Hum. Reprod., March 1, 2003; 18(3): 653 - 654.
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Home page
 Hum ReprodHome page
D.J. Cahill
What role does decreased ovarian reserve play in the aetiology of infertility related to endometriosis? Reply
Hum. Reprod., March 1, 2003; 18(3): 654 - 655.
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