Endometriosis Progression and In Vitro Fertilization

This study investigates the role of in vitro fertilization on endometriosis progression. Endometriosis is a hormone-sensitive disease process. It was initially suggested by case reports that endometriosis progresses substantially with in vitro fertilization. This could be due to the supraphysiologic estrogen levels introduced by gonadotropin stimulation. However, progesterone counteracts the role of estrogen in endometriosis, possibly treating the lesions, and is also increased in IVF cycles. This chapter reviews the initial evidence based on case reports and the subsequent data from case series, both retrospective and prospective, to understand the role, if any of endometriosis progression from fertility care. The changes in pain scores and surgical evidence of endometriosis will be presented, such that the reader will develop expertise in this area of reproductive medicine.