Optimising in vitro fertilisation (IVF) outcome in women with endometriosis

The etiology of endometriosis remains unclear and at the moment most of the therapeutic options are directed towards the relief of symptoms. In this context, in vitro fertilisation (IVF) overcomes anatomical distortion but our ability to influence environmental factors still seems to be limited. The improvement in pregnancy rates in endometriosis associated infertility is as important as the reduction in complications, and a careful analysis for the indications of each treatment option should be guaranteed. The use of gonadotropin releasing hormone agonists (GnRHa) for 3–6 months has shown to improve IVF outcomes, while increasing literature questions the role of surgery prior to the start of an IVF treatment cycle in views of fertility improvement. Early referral of these women to specialised centres is advised.