Endometriosis is a chronic inflammatory condition that
affects fertility and could be toxic to the
ovary.
Endometrioma per se and surgical interventions for
endometrioma significantly reduce the
ovarian reserve. Therefore, to prepare for surgical intervention for
endometrioma, the high-
risk group with decreased
ovarian reserve must be considered. There is no evidence to support the use of surgical intervention before
in vitro fertilization (IVF) to improve the reproductive outcomes of subsequent IVF in infertile
women with advanced-stage
endometriosis or
endometrioma. As surgical
treatment has few benefits, IVF could be recommended immediately for aiding
conception in these
women. However, the reproductive
prognosis of IVF may be worse in the more advanced stages of
endometriosis. When
dysmenorrhea is severe or when
cancer is suspected,
surgery prior to IVF may be necessary and justified. When the size of the
endometrioma is very large,
surgery could be required prior to IVF to facilitate access to follicles during
oocyte retrieval or to improve the ovarian response to controlled
ovarian stimulation. Prolonged pituitary
downregulation in
women with surgically diagnosed
endometriosis may be helpful to increase the clinical
pregnancy rate in subsequent IVF cycles. The purpose of this
paper was to
review the
efficiency and clinical application of the surgical intervention and IVF for infertile
women with advanced-stage
endometriosis or
endometrioma.