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Licensed Unlicensed Requires Authentication Published by De Gruyter March 10, 2021

The impact of endometriosis on the outcome of assisted reproductive techniques: role of fertility preservation

  • Daniel Necula EMAIL logo , Andrea Gmuer and Jérôme Mathis


Endometriosis is one of the most common diseases associated with infertility. It requires different therapeutic approaches, depending on the type, whether superficial, ovarian or deep endometriotic nodules, clinical presentation, age or origin of infertility. Patients with endometriosis should be considered a group of high-risk for infertility and any intervention should be planned taking this consideration into account. For many years, surgery was the only tool in improving fertility outcomes. Nowadays, it remains the gold standard for the treatment of endometriosis, but it should be carefully used because of its harmful potential, leading to premature ovarian insufficiency and further infertility. With the development of modern assisted reproductive techniques (ART), which can offer better results in terms of fertility, the role of surgery progressively decreased. Nowadays, therapeutic approach is complex and multidisciplinary teams should be guiding individual treatment for each woman. Options include medical treatment, surgery, in vitro fertilization (IVF) or oocytes/embryo/ovarian tissue cryopreservation. There is a constant effort in developing diagnostic scores, in order to predict risk of infertility and create standard of practice, offering a long-term approach in terms of fertility preservation and quality of life.

Corresponding author: Daniel Necula, Gynecology and Obstetrics Unit, Biel/Bienne Hospital, Biel, Switzerland, E-mail:

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors declare no conflicts of interest.

  4. Informed consent: Not applicable.

  5. Ethical approval: Not applicable.


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Received: 2020-11-22
Accepted: 2021-02-18
Published Online: 2021-03-10

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