Endometriosis and Fertility Outcomes Research

The University of Melbourne, Department of Obstetrics & Gynaecology MRFF-funded research group “Endometriosis: Diagnosis, Innovation and Treatment” aims to improve the quality of life for all people living with endometriosis and associated persistent pelvic pain (PPP) through research-driven improvements in diagnosis and treatment.

Recently, the European Society of Human Reproduction and Embryology (ESHRE) published their 2022 Endometriosis Guideline (https://www.eshre.eu/Guidelines-and-Legal/Guidelines/Endometriosis-guideline.aspx), updating their previous publication from 2014 (Dunselman et al, 2014).

These guidelines highlight the disappointing lack of comparative studies guiding surgical treatment for moderate and severe endometriosis with regards to ovarian reserve and fertility. There remains no comparative data to best inform treatment of endometriomas in women desiring future fertility, and no compelling evidence that surgery for deep infiltrating endometriosis improves fertility.

The authors implored researchers to focus on the value of surgery for ovarian and deep endometriosis and its effect on natural pregnancy rates, and considering patient age, endometrioma bilaterality and size, previous surgeries, adenomyosis and other factors affecting fertility. The use of validated patient stratification tools, such as the Endometriosis Fertility Index (EFI) was advised.

Researchers were asked also to further assess the impact of the extent of disease on the outcome of assisted reproductive techniques (ART), as it could assist in patient selection for these treatments. Fortunately, the study protocols for our two projects aim to provide vital data to fill in these important gaps in our knowledge of endometriosis and its implications for fertility.

Excitingly, we have begun recruiting for two of our largest aims: (1) Assessing change in Anti-Mullerian Hormone associated with surgical excision vs conservative management of endometrioma, and (2) The effect of surgical excision vs conservative management of moderate to severe endometriosis on future fertility (ELFS). These projects aim to answer several important questions concerning endometriosis.

To find out more about these projects, please visit https://www.endometriosis.org.au/