Treating deep endometriosis in infertile patients before assisted reproductive technology

Deep endometriosis (DE) causes infertility and pelvic pain. Surgical management of DE has become a topic of increasing interest in gynecological surgery. In women desirous of pregnancy, optimal management such as surgery versus first-line assisted reproductive technology (ART) for patients with seve...

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Autores principales:	Shazia Khan, Chyi- Long Lee
Formato:	article
Lenguaje:	EN
Publicado:	Wolters Kluwer Medknow Publications 2021
Materias:	deep endometriosis deep endometriosis excision deep infiltrating endometriosis infertility with deep endometriosis Gynecology and obstetrics RG1-991
Acceso en línea:	https://doaj.org/article/976463703a0a48ecae095ed98ef44d76
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spelling	oai:doaj.org-article:976463703a0a48ecae095ed98ef44d762021-11-12T10:10:38ZTreating deep endometriosis in infertile patients before assisted reproductive technology2213-307010.4103/GMIT.GMIT_154_20https://doaj.org/article/976463703a0a48ecae095ed98ef44d762021-01-01T00:00:00Zhttp://www.e-gmit.com/article.asp?issn=2213-3070;year=2021;volume=10;issue=4;spage=197;epage=202;aulast=Khanhttps://doaj.org/toc/2213-3070Deep endometriosis (DE) causes infertility and pelvic pain. Surgical management of DE has become a topic of increasing interest in gynecological surgery. In women desirous of pregnancy, optimal management such as surgery versus first-line assisted reproductive technology (ART) for patients with severe endometriosis is strongly debated. Current guidelines and literature including retrospective and prospective studies in English available on DE surgery, infertility, and pregnancy outcomes following surgery were searched in Cochrane Library with DE, DIE, Infertility, “DE surgery and pregnancy outcomes,” and “Deep infiltrating endometriosis and assisted reproduction” as keywords. The purpose was to find evidence to answer the following clinical questions: How does DE affect fertility and pregnancy? What are the possible benefits of primary surgery for DIE before in vitro fertilization (IVF)? Several studies have recently concluded that surgical removal of DE nodules might actually have a favorable impact on IVF outcomes. This is in contradiction to European Society of Human Reproduction and Embryology statement which stated that there was no evidence supporting surgical management of DE prior to ART to improve pregnancy rate; several studies have suggested that the surgical removal of DE nodules might actually have a favorable impact on IVF outcomes. Treatment of DE affecting the rectovaginal septum or bowel requires complex surgery with considerable risk of complications. This review article tries to analyze the rationale of surgical treatment of DE before ART. A balance must be struck between exposing the patient to surgical risk and improvement in pain and fertility potential. Decisions should be tailored according to the individual needs of each woman and most importantly on the ability of the surgeons.Shazia KhanChyi- Long LeeWolters Kluwer Medknow Publicationsarticledeep endometriosisdeep endometriosis excisiondeep infiltrating endometriosisinfertility with deep endometriosisGynecology and obstetricsRG1-991ENGynecology and Minimally Invasive Therapy, Vol 10, Iss 4, Pp 197-202 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	deep endometriosis deep endometriosis excision deep infiltrating endometriosis infertility with deep endometriosis Gynecology and obstetrics RG1-991
spellingShingle	deep endometriosis deep endometriosis excision deep infiltrating endometriosis infertility with deep endometriosis Gynecology and obstetrics RG1-991 Shazia Khan Chyi- Long Lee Treating deep endometriosis in infertile patients before assisted reproductive technology
description	Deep endometriosis (DE) causes infertility and pelvic pain. Surgical management of DE has become a topic of increasing interest in gynecological surgery. In women desirous of pregnancy, optimal management such as surgery versus first-line assisted reproductive technology (ART) for patients with severe endometriosis is strongly debated. Current guidelines and literature including retrospective and prospective studies in English available on DE surgery, infertility, and pregnancy outcomes following surgery were searched in Cochrane Library with DE, DIE, Infertility, “DE surgery and pregnancy outcomes,” and “Deep infiltrating endometriosis and assisted reproduction” as keywords. The purpose was to find evidence to answer the following clinical questions: How does DE affect fertility and pregnancy? What are the possible benefits of primary surgery for DIE before in vitro fertilization (IVF)? Several studies have recently concluded that surgical removal of DE nodules might actually have a favorable impact on IVF outcomes. This is in contradiction to European Society of Human Reproduction and Embryology statement which stated that there was no evidence supporting surgical management of DE prior to ART to improve pregnancy rate; several studies have suggested that the surgical removal of DE nodules might actually have a favorable impact on IVF outcomes. Treatment of DE affecting the rectovaginal septum or bowel requires complex surgery with considerable risk of complications. This review article tries to analyze the rationale of surgical treatment of DE before ART. A balance must be struck between exposing the patient to surgical risk and improvement in pain and fertility potential. Decisions should be tailored according to the individual needs of each woman and most importantly on the ability of the surgeons.
format	article
author	Shazia Khan Chyi- Long Lee
author_facet	Shazia Khan Chyi- Long Lee
author_sort	Shazia Khan
title	Treating deep endometriosis in infertile patients before assisted reproductive technology
title_short	Treating deep endometriosis in infertile patients before assisted reproductive technology
title_full	Treating deep endometriosis in infertile patients before assisted reproductive technology
title_fullStr	Treating deep endometriosis in infertile patients before assisted reproductive technology
title_full_unstemmed	Treating deep endometriosis in infertile patients before assisted reproductive technology
title_sort	treating deep endometriosis in infertile patients before assisted reproductive technology
publisher	Wolters Kluwer Medknow Publications
publishDate	2021
url	https://doaj.org/article/976463703a0a48ecae095ed98ef44d76
work_keys_str_mv	AT shaziakhan treatingdeependometriosisininfertilepatientsbeforeassistedreproductivetechnology AT chyilonglee treatingdeependometriosisininfertilepatientsbeforeassistedreproductivetechnology
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Treating deep endometriosis in infertile patients before assisted reproductive technology

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