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Endometriosis remains one of the most challenging chronic conditions to treat in gynecology. This condition is further complicated when patients concomitantly present with a history of infertility even though many will eventually progress to treatment with in-vitro fertilization (IVF). However, endometriosis presents its own unique set of challenges when preparing a patient for and performing an IVF cycle. This is especially the case when endometriomas are present and contribute to the diagnosis of advanced stage endometriosis (revised ASRM classification system, stages III-IV). In this review, we provide a summary of contemporary strategies to optimize IVF outcomes for patients with this systemic disease. Such strategies range from efforts and timing of such efforts to reduce disease burden via medical and surgical approaches, methods to optimize ovulation induction for maximizing egg/embryo yield as well as strategies to maximize success of implantation during embryo transfer. In addition, we delve into future strategies to reduce endometriosis disease burden which have the potential to improve IVF outcomes. This review provides a contemporary approach to optimizing IVF outcomes in patients with endometriosis of various stages.
Kotlyar et al. (Thu,) studied this question.