Endometriosis and infertility: Expert answers to 6 questions to help pinpoint the best route to pregnancy
Which patients are likely to benefit from medical therapy? When is surgery indicated? And when is it best to proceed to IVF? Our experts answer these and other questions.
In This Article
- The role of medical therapy
- When is surgery indicated?
- Coding and reimbursement
- Is surgery ever effective after failed IVF?
6. Is repeat surgery ever helpful?
In the treatment of endometriosis-associated infertility, repeat surgery should be avoided if no symptoms are present, says Dr. Estes. “In women with continued symptoms, the benefits of repeat surgery are small, with known risks, including the potential for adhesive disease and the iatrogenic detrimental effect on ovarian function—often in a setting of already-present decreased ovarian reserve.”
Dr. Nezhat agrees that multiple surgeries carry the potential for harm. “However, there is one caveat,” he says. “What was done at the previous surgery and how? The skill and experience of the surgeon and proper technique are of paramount importance to the surgical outcome.”
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