Fertility Considerations in Endometriosis and Adenomyosis Management

Introduction to Fertility Management

The American College of Radiology suggests that most accepted medical therapies for endometriosis, including Lupron, actively suppress fertility during the treatment period 3
GnRH agonists for at least three months provide significant pain relief for endometriosis-associated pelvic pain, according to the American College of Radiology 1, 2

Laparoscopic or open myomectomy represents the primary intervention for women with fibroids or adenomyosis desiring pregnancy, as recommended by the American College of Radiology 4, 3
Uterine artery embolization achieved spontaneous pregnancy rates of 29.5% at 1 year and 40.1% at 2 years in women with infertility and fibroids or adenomyosis, with an 81% live birth rate, according to the American College of Radiology 3
Ulipristal acetate demonstrated a 41% reduction in fibroid volume with pregnancy rates similar to matched controls without fibroids in women undergoing IVF, as reported by the American College of Radiology 3

There is no medical therapy proven to eradicate endometriosis lesions completely, as stated by the American College of Radiology 2
Women with endometriosis are at increased risk of premature ovarian insufficiency, with approximately half experiencing infertility, according to the European Society of Human Reproduction and Embryology 5
Fertility preservation should be discussed with reproductive-age women at risk of impaired fertility due to progression or surgical treatment of endometriosis, as recommended by the European Society of Human Reproduction and Embryology 5
Delaying fertility treatment while using Lupron may worsen long-term reproductive outcomes in women already at risk for diminished ovarian reserve, as reported by the European Society of Human Reproduction and Embryology 5