Zusammenfassung
Sterilität ist ein bei Endometriosepatientinnen häufiger Befund. Während operative Maßnahmen ihren Stellenwert haben, verbessert die alleinige hormonelle Therapie die Erfolgschancen nicht. Im Vergleich zu ausschließlicher Observanz scheinen Maßnahmen der künstlichen Befruchtung in allen Stadien der Endometriose einen Vorteil zu bieten, die Erfolgsaussichten sind aber im Vergleich zu alleiniger tubarer oder idiopathischer Sterilität geringer. Die Erfolgsaussicht der IVF ist dabei durchaus stadienabhängig. Ungeklärt ist nach wie vor die geeignetste Behandlung von Endometriomen und ihre Rolle für das Ergebnis einer IVF. Ultralange Stimulationsprotokolle bieten keine Vorteile gegenüber einem standardisierten Lutealphasenprotokoll. Insbesondere bei Vorliegen zusätzlicher Sterilitätsfaktoren ist die primäre IVF die Methode der Wahl.
Abstract
Infertility is a common clinical finding in patients with endometriosis. Surgical procedures have shown some benefit, whereas endocrine treatment alone does not improve fertility. Although assisted reproduction is superior to observation only, the pregnancy rate after IVF is lower than in patients with tubal or idiopatic infertility. The grade of endometriosis correlates to the pregnancy rate. The role of endometriomas in assisted reproduction is still a matter of debate. Ultralong stimulation protocols have no advantage to standard long luteal phase regimens. In particular in multifactor infertility IVF seems to be the treatment option of choice.
Schlüsselwörter
Endometriose - IVF - Fertilität
Key words
endometriosis - IVF - infertility
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Univ. Prof. Dr. Thomas Strowitzki
Abt. Gynäkologische Endokrinologie und Fertilitätsstörungen · Frauenklinik · Universitätsklinikum Heidelberg
Vossstraße 9
69115 Heidelberg
eMail: thomas_strowitzki@med.uni-heidelberg.de
