IMR Press / CEOG / Volume 30 / Issue 1 / pii/2003008

Clinical and Experimental Obstetrics & Gynecology (CEOG) is published by IMR Press from Volume 47 Issue 1 (2020). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Original Research

The association of minimal and mild endometriosis without adhesions and infertility with therapeutic strategies

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1 The University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School at Camden, Cooper Hospital/University Medical Center, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology & bifertility, Canulen, N. J. (USA)
Clin. Exp. Obstet. Gynecol. 2003, 30(1), 35–39;
Published: 10 March 2003
Abstract

Introduction: Mild endometriosis may be present in fertile or infertile women. When present in infertile women it could be merely an innocent bystander, and some other problem is causing the difficulty in conceiving, or it may in some way be directly responsi­ble for the infertility problem. Sometimes to achieve a pregnancy, only these other infertility factors need to be treated with no spe­cific treatment for the endometriosis per se. However there are some data suggesting that sometimes treating the endometriosis sur­gically may be helpful. Methods: The pregnancy outcome in women with probable endometriosis vs those without this entity (based on serum CA-125 levels) was compared with treatment rendered only to correcting ovulatory defects with no specific treatment rendered to the endo­metriotic lesions during the first six months of therapy. Another study evaluated the efficacy of laparoscopic removal of endome­triosis vs leaving the lesions untouched on pregnancy outcome in women who failed to conceive after at least eight months of all infertility factors corrected.Results: No differences in pregnancy outcome were found in women with probable endometriosis vs those without after six months of correcting ovulation defects. However, for the minority who did not conceive after such therapy, removing the endome­triosis surgically significantly improved fertility rates in the next eight months Conclusions: The probable presence of endometriosis based on symptoms, signs, or serologic evidence should prompt careful evaluation and treatment of subtle ovulatory problems, e.g., luteal phase defects and luteinized unruptured follicle syndrome. The­rapeutic strategies for those women failing to conceive after six to eight months of conservative therapy could be laparoscopic removal of observed endometriotic implants or consideration of in vitro fertilization.

Keywords
Endometriosis
Luteal phase defect
Progesterone
Luteinized unruptured follicle
Laparoscopy
In vitro fertilization
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