Endometriosis with Infertility,Surgery or Assisted Reproductive Technologies?

MAO Yun-dong

Abstract：Endometriosis is a common gynecologic disease with complex pathogenesis. It is very hard to treat. There are at least 25%-35% infertile female with endometriosis. Expectant treatment for infertility patient with endometriosis should not be recommend, and medication should also not be used for increasing the spontaneous pregnancy rate in many guidelines from Europe/USA/China. Surgery and assisted reproductive technologies (ARTs) are important treatment methods, but there are some debates in the strategy and opportune moment of treatment. In this review, we discussed some options on surgery and/or ART for infertility with minimal/mild endometriosis, surgery indication and opportunity in infertility with moderate/severe endometriosis, ovary protection during operation and effect of surgery on ovarian function, dispose after surgery and estimate of pregnancy rate, treatment for recurrent endometriosis with infertility, treatment for infertility with suspected endometriosis, pretreatment with GnRHa before ART in infertility with endometriosis. At last, we present our proposals on the treatment of endometriosis with infertility.