Infertility set in context

doi:10.1136/bmj.39121.866238.1F

BMJ 2007;334:328 (17 February), doi:10.1136/bmj.39121.866238.1F

Letters

Endometriosis

Infertility set in context

The first 150 words of the full text of this article appear below.

With an evidence based approach, Farquhar reviews the most outstandingaspects of endometriosis.¹ Nevertheless, we were left with theimpression that some important issues are in need of furtherclarification.

A systematic review has shown an improvement in pregnancy ratesafter laparoscopic treatment of endometriosis for women withinfertility,² but it is important to outline that, at the moment,this improvement seems to be true only for mild or minimal endometriosisand its effect on more advanced stages remains uncertain.³⁴

A recurrence of endometriosis does not inevitably mean furthersurgery. The evidence supporting systematic surgery for asymptomaticendometriosis is poor, and it has been suggested that re-operationis not always indicated for recurrent endometriosis. Transvaginalaspiration might prove to be a reasonable alternative for somepatients to reduce impact on ovarian reserve as well as otherpotential surgical complications associated with re-operation.³

Whether endometriosis affects outcomes in the context of . . . [Full text of this article]

Alejandro Chavez-Badiola, Andrew J Drakeley, subspecialist consultant in reproductive medicine

Hewitt Centre for Reproductive Medicine, Liverpool Women's Hospital. Liverpool L8 7SS

alejandro_bad@yahoo.it