Chapter 42: Endometriosis and Effects on Fertility

Hilgers TW

Endometriosis Fertility and Outcomes

Chapter 42: Endometriosis and Effects on Fertility

Hilgers TW

The Medical and Surgical Practice of NaProTECHNOLOGY, 561-572, 2004

RRM Academy Synopsis

Endometriosis is strongly linked to infertility, and surgery may help

Endometriosis is strongly linked to infertility, a 2004 textbook chapter reports. The expert review covers how the disease forms, where it grows, and how it may harm conception. The chapter argues that surgical removal of the disease improves fertility.

Key Findings

A cited surgical series of 1,785 patients found the disease on the peritoneum most often, then the ovary, and relatively rarely on the fallopian tubes.
An Endometriosis Association analysis of 3,020 case histories listed dysmenorrhea, pelvic pain, dyspareunia and infertility among the symptoms tied to endometriosis.
Pelvic lymph nodes held endometriosis in approximately 30 percent of women with the disease, a finding the chapter cites.
Peritoneal fluid from infertile women with endometriosis was toxic to mouse embryo growth and detrimental to mouse sperm-ova interaction.
A cited meta-analysis pooled 22 studies of minimal and mild disease and found surgery better than none or medical care. A 13-study comparison of none versus medical care found no difference.

RRM Context

Restorative reproductive medicine looks for the cause of infertility and treats it. Surgery can find and remove endometriosis, and the chapter describes ovulation and hormone problems alongside it. IVF goes around the pelvis and leaves the disease in place. Restorative evaluation covers both partners.

Our editorial summary of this paper, not the article's abstract.

Abstract

This chapter describes endometriosis, its diagnosis by laparoscopy with histological confirmation, its anatomic distribution and possible causes, and its association with infertility. In a series of 152 patients who underwent conservative surgery for endometriosis, 77.6 percent had limited or dry mucus cycles on CREIGHTON MODEL System charting. Pope Paul VI Institute data show a luteal phase defect in 54 percent of 228 patients with infertility and endometriosis, most often Type II, and an abnormal ovulation pattern by serial ultrasound in 60.3 percent of 331 patients. The chapter describes endometriosis as a surgical disease, states that no medication can be used effectively for endometriosis-associated infertility, and cites a meta-analysis showing the superiority of surgical treatment for endometriosis-related infertility.

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Topics

Endometriosis › Fertility and Outcomes › Conception After Excision · Reproductive Surgery › Laparoscopy › Operative Documentation · Clinical Guidelines and Standards › Diagnostic Criteria and Classification › Staging and Classification Systems

Thomas W Hilgers

Tom Hilgers, T Hilgers

Hilgers et al. 2004, Hilgers 2004

Chapter 42: Endometriosis and Effects on Fertility

Endometriosis is strongly linked to infertility, and surgery may help

Key Findings

RRM Context

Abstract

Read the guides

Topics

By this author

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