We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Impact de l'endométriose profonde sur la fertilité : indications respectives de la chirurgie et de l'aide médicale à la procréation.
- Authors
Owen, Clémentine; Boujenah, Jeremy; Cohen, Jonathan; Puchar, Anne; Vésale, Elie; Goldstein, Rebecca; Benoit, Louise; d'Argent, Emmanuelle Mathieu; Daraï, Émile; Bendifallah, Sofiane
- Abstract
Endometriosis is a chronic condition defined by the presence and development of endometrial glands and stroma outside the uterus. This benign condition is thought to affect about 10-15% of women of childbearing age. The pathophysiology of infertility associated with deep endometriosis remains partially elucidated. While the question of the management of endometriomas and superficial endometriosis is consensual and in favour of refraining from first-line surgery; the strategy in the situation of deep endometriosis is the subject of considerable debate justified by the low level of evidence in the published work, which explains the coexistence of multiple strategies. The main problem in a context of infertility in the presence of deep endometriosis is to choose between : (i) performing surgery to remove endometriosis lesions without compromising fertility or (ii) offering medical assistance for primary procreation (in vitro fertilisation (IVF)/ICSI). First-line IVF may be indicated when the patient has tubal alterations or when there are also spermogram abnormalities. In cases of advanced age or signs of early ovarian failure, the data do not allow a decision to be made on which option to take. In the absence of other infertility factors, it seems consistent from the data in the literature to propose first-line surgery with the aim of offering a good chance of spontaneous fertility.
- Publication
Médecine de la Reproduction, 2020, Vol 22, Issue 2, p174
- ISSN
2650-8427
- Publication type
Article
- DOI
10.1684/mte.2020.0795