Endometriosis and subfertility

Medical management of endometriosis is often contraceptive. In contrast, surgical treatment may improve the chance of spontaneous conception. There is conflicting evidence as to whether surgery improves outcomes with assisted conception, and this should be discussed with a specialist in reproductive medicine. Surgery, particularly for ovarian endometriosis, can cause a decreased ovarian reserve and fertility preservation should be considered. There is no standard approach to managing endometriosis in the fertility setting. It is important to take a holistic approach to diagnosis and management of the subfertile couple where endometriosis may be a contributing factor.