Endometriosis-related infertility

Endometriosis can cause infertility by producing adhesions around fallopian tubes and ovaries, and endometriomas in the ovaries. It may also interfere with fertilisation or implantation of embryos, although there is less evidence for this. Endometriosis can cause deep dyspareunia, which may reduce the frequency of intercourse.

Laparoscopic surgery is preferred to drug therapy for infertility caused by endometriosis. Surgery requires specific expertise in endometriosis management, because it may involve extensive excision and ablation of endometriotic deposits and dividing adhesions. Deposits on the ovary should not be excised because there is a risk of depleting oocytes.

In-vitro fertilisation  (IVF) may be required if significant tubal obstruction remains after surgery. Success rates are slightly lower than in other conditions treated with IVF.

For information on the management of endometriosis, see Approach to treating endometriosis. Hormonal therapies used to treat other aspects of endometriosis may interfere with conception and are not suitable for females trying to conceive.