Endometriosis, a chronic and often painful gynecological condition, continues to challenge women of reproductive age. Characterized by the presence of endometrial-like tissue outside the uterine cavity, it affects an estimated 10–15% of women globally and nearly 40% of those with infertility. For many women, endometriosis does not just cause pelvic pain, it disrupts hormonal balance, ovarian reserve, and the intricate reproductive environment essential for conception.
In this evolving landscape, Assisted Reproductive Technology (ART) has emerged as a beacon of hope for women with endometriosis-related infertility.
Endometriosis contributes to infertility through multiple mechanisms distorted pelvic anatomy, adhesions, altered peritoneal environment, inflammatory cytokine release, and impaired oocyte quality. Ovarian endometriomas, in particular, can reduce ovarian reserve and affect response to stimulation. Even in women with minimal or mild disease, subtle alterations in folliculogenesis and implantation can significantly reduce conception rates.
When natural conception fails or surgical intervention does not restore fertility, ART particularly in vitro fertilization (IVF), offers an effective pathway to pregnancy. IVF helps bypass many barriers imposed by endometriosis by facilitating fertilization outside the hostile peritoneal environment and allowing the selection of high-quality embryos for transfer.
Studies consistently demonstrate that IVF outcomes in women with endometriosis, although slightly lower compared to those with other causes of infertility, are substantially improved with individualized protocols and expert care. Pre-treatment with GnRH agonists for 2–3 months, meticulous ovarian stimulation, and advanced embryology techniques such as ICSI (Intracytoplasmic Sperm Injection) and blastocyst culture have significantly enhanced success rates.
The management of endometriosis-associated infertility should be tailored. Women with minimal or mild disease may benefit from superovulation with intrauterine insemination (IUI) before proceeding to IVF. In advanced cases, IVF is the preferred approach, especially when anatomical distortion or diminished ovarian reserve limits natural conception.
The decision to perform surgery before ART must be judicious. While cystectomy for endometriomas may relieve pain and improve access to follicles, unnecessary surgery can further reduce ovarian reserve. Hence, a multidisciplinary evaluation involving reproductive endocrinologists, laparoscopic surgeons, and embryologists is crucial.
At Milann Academy, we are committed to nurturing the next generation of reproductive specialists through advanced training and skill-based learning. Our courses are designed to bridge the gap between theory and clinical practice, empowering healthcare professionals to provide the highest standard of fertility care.
At Milann Academy, we provide advanced education and training for gynecologists and infertility specialists. Through structured courses and case-based learning, the Academy equips clinicians with the latest knowledge and skills to enhance ART outcomes.
Milann Academy provides a blend of academic depth and hands-on clinical learning guided by leaders in reproductive science.If you are a gynecologist or fertility practitioner eager to sharpen your understanding of hormonal infertility and bring precision to your clinical decisions, Milann Academy invites you to upskill, innovate, and grow with us.
Because understanding hormones like prolactin isn’t just about treating infertility, it’s about transforming outcomes, one patient at a time.
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