Endometriosis and infertility: insights into the causal link and management strategies

Publication date: Available online 18 June 2018 Source:Best Practice & Research Clinical Obstetrics & Gynaecology Author(s): Carla Tomassetti, Thomas D’Hooghe When evaluating the correlation between endometriosis and infertility with application of the evidence-based guidelines to establish causality in medicine, it becomes apparent that endometriosis causes infertility. This is supported by a strong and consistent association between the two in various settings (prevalence, natural conception, IUI and ART), evidence for a temporal relation, arguments for a dose-response gradient, and proven effects of removal of lesions on infertility. Next to surgical treatment of endometriosis lesions, medically assisted reproduction treatments such as intra-uterine insemination (IUI) and assisted reproductive technologies (ART) like in vitro fertilization are cornerstones of the management of endometriosis-related infertility. Since the rASRM staging system is poorly correlated with pregnancy rates as opposed to the Endometriosis Fertility Index (EFI), the latter should be used as the preferred clinical tool to counsel patients on their postoperative fertility management options.
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - Category: OBGYN Source Type: research