Medicina Fluminensis, Vol. 49 No. 2, 2013.
Review article
Endometriosis and infertility
Mirela Markanović Mišan
; Djelatnost za ginekologiju, Opća bolnica Pula, Pula
Neda Smiljan Severinski
; Klinika za ginekologiju i porodništvo, KBC Rijeka, Rijeka
Abstract
Endometriosis is complex disease with wide range of prevalance in relation to age,
with various type and severity of symptoms, anatomic disemination, and responses to treatment.
There are many classification systems of the disease, to unificate diagnostic criteria and
disease disemination.. No one is generally accepted because there is no correlation with a
chance of concieving after treatment. There are discrepances about fact that endometriosis is
connected with infertility. The major problem is that more associated problems exsist in the
same time in couple, connected with lower fecundity rate. In the patients with minimal and mild
endometriosis the chance for spontaneous concieving is similar to those with idiopathic infertility
or little worse. The approach to this group of patients is expectative during two years if there
is no additional fertility problems. Medicamentous treatment is effectiv in the cases of pelvic
pain and when menstrual cycle regulation is necessary, and signifficantly influence quality of life.
There are no evidences that medicamentous treatment of pelvic pain influences the fertility. In
the literature there are different opinions about surgical treatment of endometriosis in infertile
patients, and professional societies as ESHRE (European Society of Human Reproduction and
Embryology), ASRM (American Society for Reproductive Medicine) and RCOG (Royal College of
Obstetricians and Gynaecologists) are given gudelines for surgical treatment of endometriosis in
infertility. In vitro fertilisation is undobtedly most effective therapy for infertility connected with
endometriosis. Stil is unknown if endometriosis influence succes of the IVF treatment. The IVF
procedure optimise fecundity, especially in patients with medium and severe endometriosis
with anatomical distortion of pelvic organs.
Keywords
endometriosis; infertility; treatment
Hrčak ID:
103481
URI
Publication date:
5.6.2013.
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