An approach to endometriosis with infertility.

Owing to the lack of an ideal treatment for endometriosis when fertility must be preserved, there are differences of opinion between those in favour of a mainly surgical approach to therapy, those favouring expectant management of the disease's less severe forms and those who prefer an active medical approach. Such controversy has made endometriosis a constantly reviewed subject. According to the figures published in the medical literature regarding different treatment strategies for improving fertility in endometriosis cases, none of them shows any clear advantage over the next. Apparently, in minimal endometriosis, the expectation and correction of associated factors should produce identical results to any other therapy. Severe endometriosis should be treated surgically, since no response can be expected from medical therapy. Discussion on the best way to proceed arises in moderate endometriosis. The selection of the clinical treatment should be individualised with regard to the patient's condition: age, length of infertility, degree of severity of the condition, the patient's wishes and the surgical risks involved.