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Abstract

The present study evaluated the effectiveness of various endometriosis treatment methods in restoring fertility in 120 women of reproductive age with a confirmed diagnosis. The patients were divided into three groups: surgical treatment (n=40), conservative therapy (n=40), and a combined approach (n=40). The results showed the advantage of combination therapy with a pregnancy rate of 57.5% versus 35.0% for surgical and 22.5% for conservative treatment. The surgical method demonstrated efficacy in stages I-II (41.7%), but was accompanied by a decrease in the level of anti-Muller hormone from 3.2±1.5 to 2.1±1.0 ng/ml. In all groups, there was an improvement in endometrial parameters (thickness increased from 6.1±1.2 to 7.8±1.4 mm) and a decrease in systemic inflammation (C-reactive protein decreased from 8.2±3.1 to 3.5±1.8 mg/l). The greatest improvement in the quality of life was recorded in the combined group (a decrease in the scores of the Endometriosis Health Profile questionnaire-30 from 68.2±12.4 to 28.7±8.3). The information gathered demonstrates that the best course of action is combined therapy with assisted reproductive technologies, particularly during phases III–IV, while surgical treatment may be the method of choice in the early stages in patients with preserved ovarian reserve, which justifies the need for a personalized approach taking into account the stage of the disease and the reproductive status of the patient‎.

Keywords: Endometriosis, Infertility, Fertility, Surgical treatment, Combination therapy, Assisted reproductive technologies

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