Treatment of fertility ass endometriosis

Question 1

Hormonal tx for fertility in edometriosis

Answer 1

No benefit and should not be offered

Question 2

Surgical tx for fertility in endometriosis

Answer 2

• Infertile women with stage I/II endometriosis, clinicians should perform operative laparoscopy
• Spontaneous conception post surgery: 57–69% (moderate endometriosis) and 52–68% (severe endometriosis)
• CO2 laser vaporization of endometriosis, instead of
  monopolar electrocoagulation, is associated with higher cumulative spontaneous pregnancy rates

Question 3

Surgery for endometrioma and fertility

Answer 3

• Perform excision of the endometrioma capsule
• Risks of reduced ovarian function after
  surgery and the possible loss of the ovary. The decision to proceed with surgery should be considered carefully if the woman has had previous ovarian surgery