Laparoscopic treatment of endometriosis focusing on fertility outcomes

Most endometriosis patients have fertility complaints and, in spite of the improvement of assisted reproduction procedures, outcomes remain unsatisfactory. This suggests that there are unknown ethiopathogenic influences that adversely affect fertility. Laparoscopic treatment of endometriosis is of questionable efficiency with regard to achieving better fertility results, with controversies mainly surrounding ovarian residual reserve. However, the laparoscopic approach follows good practice principles and is considered a minimally invasive procedure, with the advantage of being diagnostic and therapeutic. Decision to excise endometriomas must be taken cautiously, considering factors such as patient s age, previous ovarian reserve, previous pelvic surgery, presence of pain or malignancy suspicion, disease extension and the mean diameter of the lesions.