Endometriosis and fertility

Q3 Medicine

Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2024-09-19 DOI:10.1016/j.ogrm.2024.08.006

Karolina Skorupskaite, Harish M Bhandari

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引用次数: 0

Abstract

Endometriosis is a chronic inflammatory condition of reproductive age which can lead to infertility and chronic pelvic pain. Endometriosis-associated infertility is not well understood and it appears to be multi-factorial; mechanical, inflammatory, hormonal, genetic and environmental processes can disturb each step of the normal reproductive physiology; folliculogenesis, ovulation, sperm function, gamete transport, fertilization and implantation. Medical management has limited role for patients with endometriosis wishing to conceive. On-going pregnancy rate for infertile patients with milder disease is improved by surgery. Surgical management of severe disease and endometrioma for infertility needs careful consideration as the evidence for benefits of improved reproductive outcome lacks consistency but is associated with increased surgical risks and can lead to iatrogenic decline in ovarian reserve and fertility. Endometriosis-associated infertility is a recognized indication for assisted reproductive technology procedures. Fertility preservation may be appropriate for those with risk factors for premature endometriosis-related fertility loss.

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子宫内膜异位症与生育

子宫内膜异位症是一种育龄期慢性炎症，可导致不孕和慢性盆腔疼痛。与子宫内膜异位症相关的不孕症尚不十分清楚，它似乎是由多种因素造成的；机械、炎症、激素、遗传和环境过程会干扰正常生殖生理的每一个步骤；卵泡生成、排卵、精子功能、配子运输、受精和着床。对于希望怀孕的子宫内膜异位症患者来说，药物治疗的作用有限。对于病情较轻的不孕患者，手术治疗可提高持续妊娠率。对病情严重的不孕症患者和子宫内膜异位症患者进行手术治疗需要慎重考虑，因为缺乏一致的证据表明手术治疗可改善生殖效果，但手术风险增加，可能导致卵巢储备和生育能力的先天性下降。子宫内膜异位症相关不孕症是公认的辅助生殖技术手术适应症。对于那些有子宫内膜异位症相关生育力过早丧失风险因素的患者来说，保留生育力可能是合适的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Obstetrics, Gynaecology and Reproductive Medicine Medicine-Obstetrics and Gynecology

CiteScore

0.90

自引率

0.00%

发文量

期刊介绍： Obstetrics, Gynaecology and Reproductive Medicine is an authoritative and comprehensive resource that provides all obstetricians, gynaecologists and specialists in reproductive medicine with up-to-date reviews on all aspects of obstetrics and gynaecology. Over a 3-year cycle of 36 issues, the emphasis of the journal is on the clear and concise presentation of information of direct clinical relevance to specialists in the field and candidates studying for MRCOG Part II. Each issue contains review articles on obstetric and gynaecological topics. The journal is invaluable for obstetricians, gynaecologists and reproductive medicine specialists, in their role as trainers of MRCOG candidates and in keeping up to date across the broad span of the subject area.