Endometriosis Follow Up

Complications

The complications of endometriosis include pain, fertility problems, and the risk of developing ovarian cancer.

Endometriosis-Related Infertility  

It is important to perform infertility evaluation to identify potential causes in both partners. When developing a management plan, factors such as the woman’s age, length of infertility, presence of pelvic pain, and severity of endometriosis should be considered. For patients with significant symptoms suggestive of endometriosis (eg pain, dysmenorrhea, dyspareunia) who have not had primary surgical treatment, diagnostic and operative laparoscopy with ablation or excision of endometriosis implants may be performed. For patients who have undergone a primary surgical treatment of endometriosis, the potential risks of major surgery must be weighed against the limited benefits of another operative procedure as repeat surgical treatment does not improve fertility. In women <35 years old with mild endometriosis (stage I/II), expectant management (6 months of timed intercourse) or superovulation (SO) with intrauterine insemination (IUI) can be considered. In women ≥35 years old, more aggressive treatment such as SO/IUI or in vitro fertilization (IVF) may be considered. Use of GnRH agonist for 3-6 months in IVF can increase pregnancy rates. For patients with advanced endometriosis (stage III/IV), IVF is an effective treatment option.