Comparative Analysis of assisted reproductive technology versus Standard Care in endometriosis
DOI:
https://doi.org/10.5281/zenodo.22813807Keywords:
endometriosis, assisted reproductive technology, in vitro fertilization, infertility, endometriomaAbstract
Background: Endometriosis is identified in roughly a quarter to a half of infertile women, and clinicians have long debated whether standard care or assisted reproductive technology (ART) better restores fertility across disease stages [1,2].
Objective: This analysis compares the standard-care and ART literatures to identify the disease stages under which each strategy, or a staged combination, offers the more favourable balance of live birth rate and time to pregnancy.
Methods: We conducted a narrative synthesis of randomized trials, Cochrane reviews, ART registry cohorts, and guidelines on ART versus standard care in endometriosis-associated infertility, stratified by rASRM stage and endometrioma status [14,15].
Findings: In minimal-mild disease, excision followed by expectant conception offered a modest benefit [8,10]; in moderate-severe disease, IVF live birth rates were lower than tubal-factor controls [12,13]; cystectomy before IVF reduced ovarian reserve without improving outcomes [17,18], while prolonged GnRH agonist down-regulation improved pregnancy rates [26,27].
Conclusions: ART and standard care are complementary strategies whose value shifts with stage, endometrioma status, and age; a staged, severity-informed algorithm better serves patients than a fixed sequence [19,16].
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