“The management of endometriosis is not one size fits all. With few exceptions, treatments should not be focused on lesions, but on clinical problems, and the most effective measures should be adopted to overcome the specific issue that is most important in the opinion of the woman.
Some patients may prefer surgery in order to avoid hormonal therapies, whereas some others may prefer medications with the objective of avoiding surgery. Some women may choose surgery to increase the chances of natural conception, some others may prefer IVF in order to limit the periods of time without medical treatments.
The duty of the caring gynecologist is to inform the woman on the pros and cons of each option and support her in the shared decision-making process. The physician should be able explain in detail all the available treatments, and not only those that the physician prefers or is able to offer. Paternalistic medicine is over, also in the endometriosis field. It was time.”
The above is an extract from Fertlity Sterility as quoted by Professor Paolo Vercillini.