I-27: ART Protocols in Endometriosis

Treatment strategies for the infertile couple with endometriosis must be based on the specific situation. Traditional medical therapy for endometriosis, such as progestins, danazol, and GnRH agonists, have been shown to have little impact on enhancing spontaneous pregnancy rates despite well described beneficial effects on reducing pain. For the young women with only minimal or mild endometriosis, expectant management may be the most appropriate treatment modality. However, for women approaching the end of their reproductive age, the chances of conceiving drop precipitously .In these women, intervention, in the form of COH/IUI, or in vitro fertilization (IVF) seems more rational. For women with severe endometriosis, or when malefactor or a combination of etiologies are involved, assisted reproduction is more reasonable. Considering the optimal stimulation protocol in endometriotic patients, it seems that they respond to ovarian stimulation in a manner that is similar to other infertility etiologies. Long-termGnRH agonist suppression has been thought to improve IVF outcome for patients with endometriosis .The length of suppression varied from 6 weeks to 7 months. The mechanism of action for this effect has not been established. Recently aromatase inhibitors are added to therapeutic modalities for the treatment of endometriosis-associated pain. With its efficacy in treating there are studies, to