Medication In addition to pain control, medical management of<unk>  targets the suppression of hormonally active endometriotic tissue. Standard pharmacotherapy for women diagnosed with<unk>  include: * Analgesics (eg non-steroidal anti-inflammatory drugs (NSAIDs) or acetaminophen) * Oral contraceptive pills * Androgenic agents (eg danazol) * Progestogens (eg medroxyprogesterone acetate) * Gonadotropin releasing hormone analogues (GnRHas) * Anti-progestogens (eg gestrinone) Other than the analgesics, all these medications attempt to suppress follicle growth, induce amenorrhea, and suppress endometriotic lesions to improve fertility. However, as many of these therapies have contraceptive effects, they are not ideal for women seeking fertility. Instead, they postpone pregnancy and imply side effects. A second strategy is to stimulate follicle growth and ovulation. Clomiphene citrate, both alone or in combination with gonadotropins, is the most commonly prescribed. Aromatase inhibitors have also been used for follicle stimulation, but their efficacy have not been isolated. Immunomodulators such as interferon alpha 2 (IFN-α 2) and tumor necrosis factor (TNF)-α inhibitors are being studied in women with severe<unk> . A study that included nineteen women received Etanercept before an IVF cycle showed a higher pregnancy rate compared to women who were not treated. Further studies still need to be done in order to determine the risk of infectious adverse events. Surgery Surgical intervention of<unk>  is indicated for both diagnostic and therapeutic purposes. It can be utilized for the diagnosis and treatment of endometriotic adhesions, as a second-line treatment following the failure or intolerance of pharmacotherapy, or for treatment of<unk>  in some patients. The goal of surgical intervention in mild<unk>  is to destroy or remove endometriotic implants, which has been shown to successfully improve fertility. Possible types of surgeries include excision, electrodiathermy, or laser. The goal of surgical intervention in moderate/severe<unk>  is not only to remove large endometriomas, but also to restore the normal anatomy of the pelvis. However, there are no RCTs comparing these surgeries with medical or non-treatment. Ideally, surgery would be performed to diagnose while simultaneously treating. This can minimize exposure to multiple surgeries. In cases of severe<unk> , lesions may or may not be limited to the pelvic area, and may require advanced ultrasound in order to create a more accurate surgical plan. Compared to hormonal suppression, surgery is more effective at treating<unk>  in women who suffer from<unk> , especially for women with mild to moderate<unk> . While surgery can enhance the chances of conceiving naturally during the 12-18 ensuing months, the removal of ovarian endometriomas may be more risky and cause potential harm on future reproductive success. For this reason, there are certain criteria that a surgeon must take into account beforehand in order to have minimal effect on ovarian reserve. Bilateral versus unilateral cystectomy of endometriomas can reduce ovarian reserve, as well as recurrent endometrioma excisions. Combination of surgery and postoperative hormonal suppression therapy can also reduce the risk of recurring lesions and pain symptoms. Laparoscopic excision of endometriomas has been shown to have better health outcomes including shorter post-operative recovery times, shorter hospital stays and decreased hospital costs compared to other<unk> -associated surgeries. However, the preferred surgical procedure is unclear in women who plan to undergo fertility treatment post-operation. Intrauterine insemination In women with minimal to mild<unk> , as defined by the American Society for Reproductive Medicine, intrauterine insemination is the preferred treatment; however, the effects are modest if used as a monotherapy. The use of fertility medication that stimulates ovulation (clomiphene citrate, gonadotropins) combined with intrauterine insemination (IUI) enhances fertility in this population as does assisted reproduction. IUI is not given to women with moderate to severe<unk>  due to damage and scarring of the fallopian tubes associated with<unk> . In vitro fertilization In-vitro fertilization (IVF) procedures are effective in improving fertility in many women with<unk> , especially in those who experience severe<unk> . Discounting those with damage to the oocytes and embryos, IVF procedures have yielded similar results in increasing fertility among both women with and without<unk> . IVF makes it possible to combine sperm and eggs in a laboratory and then place the resulting embryos into the uterus. The decision when to apply IVF in<unk> -associated<unk>  cases takes into account the age of the individual, severity of the<unk> , presence of other<unk>  factors, and the results and duration of past treatments. In ovarian hyperstimulation as part of IVF for women with<unk> , using a standard GnRH agonist protocol has been found to be equally effective in regard to using a GnRH antagonist protocol in terms of pregnancy rate. On the other hand, when using a GnRH agonist protocol, long-term (three to six months) pituitary down-regulation before IVF for those with<unk>  has been estimated to increase the odds of clinical pregnancy by fourfold. No difference has been found between surgery (cystectomy or aspiration) versus expectant management, or between ablation versus cystectomy, prior to IVF in women with<unk> . Utilizing IVF procedures prior to<unk> -associated surgery has not been shown to enhance fertility compared to utilizing IVF procedures post-surgery.
Endometriosis and infertility
Diabetes and pregnancy
Hinduism and abortion
Lupus and pregnancy
symptoms of Endometriosis
symptom of Pregnancy
Infertility in polycystic ovary syndrome
Early pregnancy bleeding