ABSTRACT
Endometriosis as a clinical entity has been recognized and intensely investigated for well over 100 years. Despite the accumulation of an enormous amount of information, uncertainty still exists regarding etiologies, clinical consequences, and treatment efficacy. The two most common complaints leading to a diagnosis of endometriosis are pelvic pain and infertility. Newly developed and innovative medical and surgical approaches, such as gonadotropin releasing hormone (GnRH) agonists and laparoscopically guided laser ablation, have proven quite effective in improving many of the symptoms associated with endometriosis. However, on their own, these treatments have largely failed to improve fertility in patients with endometriosis, which has led some to question the existence of a causal relation between the disease and impaired reproduction. Nevertheless, it does appear that assisted reproductive technology is becoming an indispensable asset in providing affected couples with viable pregnancies, although the nearly complete absence of adequate prospective trials has left many questions regarding protocol and efficacy unanswered.
