Endometriosis and endometrial pathology in IVF

Endometriosis and IVF

When endometriosis includes the fallopian tubes and ovaries, it can cause fertility reduction. The basic mechanism by which endometriosis affects fertility is the formation of adhesions. An important inflammation caused by this disease modifies the anatomy of the gynecological apparatus.

There are different forms of endometriosis. Doctors defineperitoneal endometriosis when they observe only small peritoneal lesions. They define ovarian endometriosis in the presence of endometriotic cysts on the ovaries. When endometriosis includes all the organs of the pelvic apparatus it is the most severe form called also frozen pelvis. In the latter case doctors observe the nodules of endometriosis which are inflammatory structures usually behind the uterus.

Surgeons must absolutely operate ovarian and deep endometriosis. Peritoneal endometriosis is a subject of debate because according to some studies it does not affect fertility. According to other studies we must operate, burn and immediately after seek pregnancy.

IVF vs surgery or both?

With regard to the peritoneal form and the ovarian form we recommend first of all surgery. Then we advise to try spontaneously. In the case of deep endometriosis, we recommend to switch to IVF after the operation.

Impact of endometriosis on IVF

Today we consider that the presence of ovarian and deep endometriosis can alter the oocyte quality thus compromising the final outcome of ovarian stimulation.

Intra-uterine polyps and IVF

Intra-uterine polyps are related to infertility.
In addition, their presence increases the possibility of spontaneous abortion even after IVF. We must always remove endometrial polyps.