J Korean Med Assoc.  2019 Oct;62(10):519-524. 10.5124/jkma.2019.62.10.519.

Endometriosis and infertility

Affiliations
  • 1Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. kimsung@amc.seoul.kr

Abstract

Endometriosis is a chronic inflammatory disease that affects 10% to 15% of all women of reproductive age. Several studies show an association between endometriosis and infertility; however, clear causality remains unproven. The association between endometriosis and infertility is attributable to distorted pelvic anatomy secondary to adhesions, altered endocrine and ovarian function, impaired uterine implantation, and poor quality of oocytes/embryos. Medical treatment shows limited efficacy, without any evidence to support its role in improving fertility. Surgical treatment can improve ongoing pregnancy rates in minimal-to-mild endometriosis, although this approach may cause inevitable ovarian injury in women with ovarian endometrioma. Tailored treatment should be used in women with infertility and endometriosis. Age, ovarian reserve, a history of ovarian surgery, and bilateral endometriomas are important factors that should be carefully considered in these cases.

Keyword

Endometriosis; Infertility; Ovarian reserve; Surgical treatment; Assisted reproductive technology

MeSH Terms

Endometriosis*
Female
Fertility
Humans
Infertility*
Ovarian Reserve
Pregnancy Rate
Reproductive Techniques, Assisted

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