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Semin Reprod Med 2003; 21(2): 243-254
DOI: 10.1055/s-2003-41330
Copyright © 2003 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Endometriosis and Subfertility: Is the Relationship Resolved?

Thomas M. D'Hooghe1 , Sophie Debrock1 , Joseph A. Hill2 , Christel Meuleman1
  • 1Leuven University Fertility Center Department of Obstetrics Gynecology, University Hospital Gasthuisberg Leuven, Belgium
  • 2Fertility Center of New England, Reading, Massachusetts
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Publication History

Publication Date:
14 August 2003 (online)

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ABSTRACT

There are many arguments to support the hypothesis that there is a causal relationship between the presence of endometriosis and subfertility. These arguments are reviewed in this article and include: (1) an increased prevalence of endometriosis in subfertile women compared with women of proven fertility; (2) a reduced monthly fecundity rate (MFR) in baboons with mild to severe (spontaneous or induced) endometriosis compared with those with minimal endometriosis or a normal pelvis; (3) a trend toward a reduced MFR in infertile women with minimal to mild endometriosis compared with women with unexplained infertility; (4) a dose-effect relationship: a negative correlation between the r-AFS stage of endometriosis and the monthly fecundity rate and crude pregnancy rate; (5) a reduced monthly fecundity rate and cumulative pregnancy rate after donor sperm insemination in women with minimal-mild endometriosis compared with those with a normal pelvis; (6) a reduced MFR after husband sperm insemination in women with minimal to mild endometriosis compared with those with a normal pelvis; (7) a reduced implantation rate per embryo after IVF in women with moderate to severe endometriosis compared with women with a normal pelvis; and (8) an increased monthly fecundity rate and cumulative pregnancy rate after surgical removal of minimal to mild endometriosis.

KEYWORDS

Minimal - mild - moderate - severe endometriosis - subfertility - monthly fecundity rate - cumulative pregnancy rate

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