Key Points on Infertility & Endometriosis from Cochrane

March is Endometriosis Awareness Month. Approximately 11% of people experience endometriosis in the United States, a painful condition that causes uterine tissue to grow outside of the uterus and can cause difficulty becoming pregnant. People with endo and hoping to become pregnant or currently struggling with fertility should be able to learn as much as possible about their options and treatment that can improve chances of pregnancy. Cochrane, which is an international network of researchers, health professionals, and patients producing high quality and reliable health information, offers a wealth of resources about endometriosis, including the latest evidence on "keyhole surgery" for treating infertility caused by the disease. Here are key takeaways from the article:

• Between 30-50% of people with endometriosis experience infertility issues. 
• The majority of people with mild endometriosis do not have fertility difficulties (50-75%) and can become pregnant without treatment. 
• The usual recommendation is to try for pregnancy for a year before seeking a fertility specialist, but depending on your age and the severity of endometriosis, you should talk to your doctor about seeing a specialist sooner. 
• Don't assume that your fertility issues are a result of endometriosis -- be sure to have a full fertility workup, including checking your partner's sperm count. 
• Currently, there is no evidence that any medicine improves a person's chance of getting pregnant with endometriosis. 
• IVF (in vitro fertilization) and IUI (intrauterine insemination) are established treatments for infertility caused by endometriosis. 
• Keyhole surgery, also known as laparoscopy, is an established way to determine the extent of endometriosis and remove deposits of the disease along with scar tissue from the uterus, fallopian tubes, and ovaries. It is a popular treatment for people experiencing endometriosis-related infertility. 
• Cochrane studies concluded there was moderate quality evidence that keyhole surgery probably increases pregnancy rates.
• The studies could not provide enough evidence about adverse events to make a conclusion about the safety of the procedure.
• Ask your fertility specialist about keyhole surgery to determine if it would be an effective treatment for you, as well as to discuss the risks, alternatives, and its potential impact on your egg count and future fertility. 

To learn more and read the complete article from Cochrane, along with videos discussing endometriosis and fertility, visit their website. You can also learn more about endometriosis on the Giving Birth with Confidence blog.

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Published: March 14, 2022

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