Fertility in endometriosis

Background: The association between endometriosis and subfertility has been well described. A multifactorial process of this systemic inflammatory disease is believed to diminish fertility on various levels. In this context, artificial reproductive technologies (ART) have gained importance.Objectives: This article aims to describe the multifactorial process of underlying endometriosis on female fertility, pregnancy outcomes, success in ART, as well as laparoscopic surgery and to evaluate the potential of "egg freezing".Materials and methods: PubMed and the most recent 2022 European Society of Human Reproduction and Embryology (ESHRE) guidelines have been used to conduct a literature research. Search terms related to fertility and endometriosis were utilized and the most recent meta-analyses and publications from high-impact journals were selected.Results/conclusions: It is well known that endometriosis and infertility are related, and ART is a successful method to overcome endometriosis-related subfertility. Indications for laparoscopic endometriosis surgery with the aim of enhancing fertility need to be carefully evaluated and may be successful only in rare cases. In the presence of low ovarian reserve, "egg freezing" may be considered. Pregnant women with endometriosis-depending on its localization and extent-require frequent monitoring due to a higher risk of miscarriage and premature birth.