Laparoscopy can provide useful information to help determine how to get pregnant and when to undergo fertility therapy. This scoring system correlates with pregnancy success. With more minimal endometriosis, removing or destroying endometriosis can increase your chances of becoming pregnant naturally. With more advanced endometriosis Stages 3 or 4 , surgery can help restore your normal pelvic anatomy to allow the ovaries and fallopian tubes to work better.
Surgery to remove large endometriomas may also improve fertility rates. There is a limit as to how much surgery can improve pregnancy rates. Treatment should be individualized and should consider all available methods to help you become pregnant.
Endometriosis is associated with an increased risk of having difficulty becoming pregnant, or infertility. Studies have shown that the amount of endometriosis that is seen at the time of laparoscopy is linked to future fertility.
Women with Stage I and II endometriosis may become pregnant on their own, however, medical studies do suggest that if laparoscopy is done in women who have infertility, they are more likely to have endometriosis than women who become pregnant with no difficulty. There is some evidence that pregnancy rates may improve if Stage I or II endometriosis is removed surgically, however some data shows that this does not help.
In general, when women are young less than 35 years old it is reasonable to remove any visible endometriosis to see if pregnancy occurs. If women are 35 or older, other fertility treatments are recommended instead of laparoscopy see below.
If Stage III or IV endometriosis is present, pregnancy rates are higher after surgery is performed to remove scar tissue or large endometriotic cysts. If pregnancy does not occur within 6 months after surgical treatment of endometriosis, other fertility treatments should be discussed. Unfortunately, some women with endometriosis can have cysts that come back. If cysts are removed over and over, this can cause a loss of eggs from the ovaries, and can make it harder to become pregnant.
Before starting any fertility treatment a complete fertility evaluation is performed. Medical treatments depend on the stage of a patient's endometriosis:. In order to improve the likelihood of pregnancy clomiphene citrate, a fertility medication, is given for 5 days soon after the menstrual period starts. At the time the egg is released from the ovary ovulation , the male partner produces a sperm sample by masturbating into a sterile cup.
The sperm is brought to the fertility laboratory and processed. Received 27 Sep Accepted 12 Jan Published 12 Jul Abstract Objective. Introduction The correlation between endometriosis and infertility is well documented, with monthly fecundity reported as 0. Results From to , women underwent fertility-preserving laparoscopic surgery by 16 different surgeons for stage III-IV endometriosis. Table 1. Figure 1. Figure 2.
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