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Endometriosis and infertility: pathophysiology and management

The Lancet (British edition), 2010-08, Vol.376 (9742), p.730-738 [Peer Reviewed Journal]

Elsevier Ltd ;2010 Elsevier Ltd ;2015 INIST-CNRS ;Copyright 2010 Elsevier Ltd. All rights reserved. ;Copyright Elsevier Limited Aug 28-Sep 3, 2010 ;ISSN: 0140-6736 ;EISSN: 1474-547X ;DOI: 10.1016/S0140-6736(10)60490-4 ;PMID: 20801404 ;CODEN: LANCAO

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Title:
Endometriosis and infertility: pathophysiology and management
Author: de Ziegler, Dominique, Prof ; Borghese, Bruno, MD ; Chapron, Charles, Prof
Subjects: Algorithms ; Apoptosis ; Biological and medical sciences ; Birth control ; Cysts ; Embryos ; Endometriosis ; Endometriosis - complications ; Endometriosis - diagnosis ; Endometriosis - physiopathology ; Endometriosis - therapy ; Female ; Female genital diseases ; General aspects ; Gynecology. Andrology. Obstetrics ; Humans ; Infertility ; Infertility, Female - etiology ; Infertility, Female - therapy ; Internal Medicine ; Medical sciences ; Non tumoral diseases ; Reproductive Techniques, Assisted ; Reproductive technologies ; Sterility. Assisted procreation
Is Part Of: The Lancet (British edition), 2010-08, Vol.376 (9742), p.730-738
Description: Summary Endometriosis and infertility are associated clinically. Medical and surgical treatments for endometriosis have different effects on a woman's chances of conception, either spontaneously or via assisted reproductive technologies (ART). Medical treatments for endometriosis are contraceptive. Data, mostly uncontrolled, indicate that surgery at any stage of endometriosis enhances the chances of natural conception. Criteria for non-removal of endometriomas are: bilateral cysts, history of past surgery, and altered ovarian reserve. Fears that surgery can alter ovarian function that is already compromised sparked a rule of no surgery before ART. Exceptions to this guidance are pain, hydrosalpinges, and very large endometriomas. Medical treatment—eg, 3–6 months of gonadotropin-releasing hormone analogues—improves the outcome of ART. When age, ovarian reserve, and male and tubal status permit, surgery should be considered immediately so that time is dedicated to attempts to conceive naturally. In other cases, the preference is for administration of gonadotropin-releasing hormone analogues before ART, and no surgery beforehand. The strategy of early surgery, however, seems counterintuitive because of beliefs that milder non-surgical options should be offered first and surgery last (only if initial treatment attempts fail). Weighing up the relative advantages of surgery, medical treatment and ART are the foundations for a global approach to infertility associated with endometriosis.
Publisher: Kidlington: Elsevier Ltd
Language: English
Identifier: ISSN: 0140-6736
EISSN: 1474-547X
DOI: 10.1016/S0140-6736(10)60490-4
PMID: 20801404
CODEN: LANCAO
Source: ProQuest One Psychology
MEDLINE
ProQuest Central

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Endometriosis and infertility: pathophysiology and management

Elsevier Ltd ;2010 Elsevier Ltd ;2015 INIST-CNRS ;Copyright 2010 Elsevier Ltd. All rights reserved. ;Copyright Elsevier Limited Aug 28-Sep 3, 2010 ;ISSN: 0140-6736 ;EISSN: 1474-547X ;DOI: 10.1016/S0140-6736(10)60490-4 ;PMID: 20801404 ;CODEN: LANCAO

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