Infertility and
endometriosis

First and foremost, it is important to know that endometriosis is by no means synonymous with infertility, it is simply a risk factor. The majority of women who have endometriosis have no difficulty in conceiving. On the other hand, among infertile women, approximately one third have endometriosis. This distinction is fundamental and is often misunderstood by both the media and patients. Taking into account a woman’s fertility at the time of diagnosis of endometriosis is nevertheless essential, for several reasons.

• The first treatment for endometriosis is medical-hormonal. It consists in blocking menstruation so as to prevent the pain of menstruation (also called dysmenorrhea), improve other pain and stop the disease from progressing. However, all treatments that suppress menstruation are contraceptive and necessarily have to be stopped for conception to occur. This timing of discontinuation of contraception is therefore very important, and can be accompanied medically, from an early stage to limit the episodes of menstruation and optimize the chances of pregnancy.
• The disease may have affected fertility, and this change should be evaluated. If necessary, fertility protection can be considered.
• In case of recourse to surgery, even in the absence of desire for pregnancy, the consequences and benefits for future fertility are to be anticipated and discussed with the patient.