ENDOMETRIOSIS AS A CAUSE OF INFERTILITY

Abstract

Introduction: Endometriosis is a chronic, benign, and inflammatory condition defined as the presence of endometrial tissue outside the uterine cavity. In addition to causing extensive and variable symptoms, it is one of the causes of infertility by altering the anatomy of reproductive organs, causing fibrosis, reducing the quality of oocytes, hindering implantation, and causing tubal occlusion. Objective: To deepen knowledge about the early diagnosis of endometriosis in order to promote appropriate treatment for patients with this comorbidity and reduce the risk of complications, such as infertility. Methodology: This is an integrative literature review, with research carried out in the scientific databases PUBMED and BVS from 2019 to 2024, using the Health Science Descriptors: “Endometriosis”, “Infertility” and “Treatment”. The inclusion criteria will be: articles available in full for free distribution, national and international articles, with publications in Portuguese, English, and Spanish. Exclusion criteria were articles that did not meet the theme, articles with unavailable abstracts and articles repeated in databases. Results and Discussion: Assisted reproductive technology (ART) procedures can overcome several infertility problems, including ovulatory dysfunction, fertilization failure and tubal damage. However, women with endometriosis may face additional difficulties in ART cycles. In women with infertility and surgically confirmed endometriosis, both surgical laparoscopy alone and the use of GnRH agonists have been shown to increase the chances of clinical pregnancy compared to placebo. There is also evidence that the use of lipiodol or the combination of surgical laparoscopy with pentoxifylline may increase the chances of clinical pregnancy, but these results should be interpreted with caution, as they were based on open-label studies. There was insufficient evidence to show a significant difference in other interventions when compared to placebo for achieving clinical pregnancy. Final Considerations: Therefore, given the complexity and diversity of endometriosis, it is extremely important that new clinical trials be conducted to investigate more effective and customizable treatments. These studies should focus not only on pharmacological and surgical therapies, but also on strategies to improve the results of in vitro fertilization and other assisted reproduction methods.