Should a laparoscopy be performed for patients with unexplained infertility to diagnose endometriosis?
Formerly laparoscopies were recommend for the evaluation of endometriosis prior to fertility treatment. Currently, if the patient is committed to treatment, and if there is no other reason for a laparoscopy, doctors will often simply proceed to treatment. • Should endometriosis ovarian cysts be surgically removed prior to start of fertility treatment? Formerly, surgery to remove endometriomas was recommended prior to treatment, especially in vitro fertilization treatment. There are some recent studies suggesting that surgical intervention may actually damage eggs around the endometrioma, decreasing pregnancy rates. Currently, your doctor may not recommend removing the endometrioma, unless it is above 6cm in size or provides symptoms. • Should all endometriosis lesions be surgically removed, if the patient does not have symptoms of pelvic pain? Current studies suggest that there may be some fertility improvement with trying to surgically remove all visible lesions, though the magnitude
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