What reproductive options are there with grade IV endometriosis?

Endometriosis affects 10-15% of women. Among those who suffer from it, around 30-50% have fertility problems and, among the latter, 25-50% have grade IV endometriosis. Endometriosis is inflammation that leads to the formation of adhesions in the pelvis. This affects women in various ways, but the main problem is that it alters the anatomical relationship between the ovaries and the fallopian tubes. In the most severe cases of endometriosis, a blockage in the tubes can occur, leading to hydrosalpinx, which may require removal before resorting to any assisted reproductive treatment.

The most appropriate approach for each couple will depend on numerous factors, including the woman’s age, the period from which she suffers fertility problems, her ovarian reserve, the results of the semen analysis or seminogram, previous surgeries to treat endometriosis and the degree of severity.

In the case of women under 35 years of age with a mild grade, it is recommended to attempt a cycle of artificial insemination. However, in the case of women aged 35 years or older who suffer from moderate or severe endometriosis (grades III and IV), IVF would be the treatment of choice directly, as it offers higher success rates. Notably, compared to other fertility problems, endometriosis offers lower success rates for IVF.

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