Chapter 11. Endometriosis-related complications in women undergoing in-vitro fertilization

Best Pract Res Clin Obstet Gynaecol. 2024 Mar:93:102456. doi: 10.1016/j.bpobgyn.2024.102456. Epub 2024 Jan 12.


As a chronic inflammatory disease, endometriosis generates fibrosis and anatomic distortion, which add extra-challenges to assisted reproductive technology cycles and requires a personalized approach. Patients with endometriomas have significantly decreased ovarian reserve and the ultrasound examination tends to be challenging, possibly underestimating follicle counts. It is crucial to assess the feasibility of oocyte retrieval procedure during the initial examination of the patient, as the distortion of the pelvic anatomy, the presence of hydrosalpinges and endometriomas might render the procedure difficult and increase the risk of complications. Possible injury to adjacent organs and risk of infection must be considered. Assisted reproductive technology seems to have limited or no impact on endometriosis recurrence, pain symptom progression or the size of endometrioma.

Keywords: Anti-Mullerian hormone; Antral follicle count; Endometrioma; Endometriosis; In vitro fertilization; Oocyte retrieval.

Publication types

  • Review

MeSH terms

  • Endometriosis* / complications
  • Endometriosis* / diagnostic imaging
  • Female
  • Fertilization
  • Fertilization in Vitro / adverse effects
  • Fertilization in Vitro / methods
  • Humans
  • Infertility, Female* / etiology
  • Infertility, Female* / therapy
  • Ovarian Follicle