Endometriosis - ESHRE guideline

Question 1

What is the prevalence of endometriosis in the general female population?

Answer 1

Unknown - estimated 2-10%

Question 2

What is the prevalence of endometriosis in infertile women?

Answer 2

Up to 50%

Question 3

What is the average diagnostic delay of endometriosis in the UK?

Answer 3

8 years

Question 4

When can aromatase inhibitors be considered for treatement of endometriosis?

Answer 4

In women with pain from rectovaginal endometriosis refractory to other medical or surgical treatment (in combination with OCPs, progestagens or GnRH analogues

Question 5

What is the risk of bilateral ovarian failure after bilateral ovarian endometrioma removal?

Answer 5

2.4%

Question 6

Which treatment is more effective in endometriomas <=3cm with regards to recurrence of pain and recurrence of endometrioma?

Answer 6

Cystectomy is superior to drainage and coagulation

Question 7

What is the complication rate in bowel surgery for deep endometriosis?

Answer 7

0-3%

Question 8

What is the recurrence rate in bowel surgery for deep endometriosis?

Answer 8

5-25%

Question 9

For what reason should post-operative hormonal therapies be prescribed?

Answer 9

For long term (>6/12) for secondary prevention particularly following cystecomy

However may not improve the outcome of surgery - not recommended for non-menstrual pelvic pain or dyspareunia as no evidence

Question 10

In women with mild-moderate endometriosis which intervention is more effective in improving ongoing pregnancy rates?

Answer 10

Operative (including adhesiolysis) > Diagnostic laparoscopy

Question 11

Which intervention for infertility increases pregnancy rates, live birth rates, compared to expectant management in minimal-mild endometriosis?

Answer 11

IUI with controlled ovarian stimulation (approx 5x higher)