European society of human reproduction and embryology guideline: management of women with endometriosis

Authors

  • G.A.J. Dunselman Research Institute GROW, Maastricht University Medical Centre, Maastricht, Netherlands
  • N. Vermeulen European Society of Human Reproduction and Embryology, Central Offi ce, Grimbergen, Belgium
  • C. Becker University of Oxford, John Radcliff e Hospital, Headington, Oxford, United Kingdom
  • C. Calhaz-Jorge CHLN/Hospital de Santa Maria, Lisboa, Portugal
  • T. D’hooghe Department of Obstetrics and Gynecology, Department of Development and Regeneration, Leuven, Belgium
  • B. De Bie Endometriose Stichting, Sittard-Geleen, Netherlands
  • O. Heikinheimo Kaёtiloёopisto hospital, Finland
  • A.W. Horne MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, United Kingdom
  • L. Kiesel University Hospital of Muёnster, Muёnster/Westf, Germany
  • A. Nap Rijnstate Arnhem, Arnhem, Netherlands
  • A. Prentice The Rosie Hospital, Cambridge, United Kingdom
  • E. Saridogan University College London Hospital, Women’s Health Division, London, United Kingdom
  • D. Soriano Endometriosis Center, Sheba Medical Center, Ramat Gan, Israel
  • W. Nelen Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands

DOI:

https://doi.org/10.18370/2309-4117.2014.19.54-67

Keywords:

endometriosis, European Society of Human Reproduction and Embryology, guideline, evidence based

Abstract

Study question: What is the optimal management of women with endometriosis based on the best available evidence in the literature?

Summary answer: Using the structured methodology of the Manual for ESHRE Guideline Development, 83 recommendations were formulated that answered the 22 key questions on optimal management of women with endometriosis.

What is known already: The European Society of Human Reproduction and Embryology (ESHRE) guideline for the diagnosis and treatment of endometriosis (2005) has been a reference point for best clinical care in endometriosis for years, but this guideline was in need of updating.

Study design, size, duration: This guideline was produced by a group of experts in the field using the methodology of the Manual for ESHRE Guideline Development, including a thorough systematic search of the literature, quality assessment of the included papers up to January 2012 and consensus within the guideline group on all recommendations.

Main results and the role of chance: The guideline provides 83 recommendations on diagnosis of endometriosis and on the treatment of endometriosis-associated pain and infertility, on the management of women in whom the disease is found incidentally (without pain or infertility), on prevention of recurrence of disease and/or painful symptoms, on treatment of menopausal symptoms in patients with a history of endometriosis and on the possible association of endometriosis and malignancy.

Limitations: We identified several areas in care of women with endometriosis for which robust evidence is lacking. These areas were addressed by formulating good practice points (GPP), based on the expert opinion of the guideline group members.

Wider implications of the findings: Since 32 out of the 83 recommendations for the management of women with endometriosis could not be based on high level evidence and therefore were GPP, the guideline group formulated research recommendations to guide future research with the aim of increasing the body of evidence.

Study funding/competing interest(s): The guideline was developed and funded by ESHRE, covering expenses associated with the guideline meetings, with the literature searches and with the implementation of the guideline. The guideline group members did not receive payment. All guideline group members disclosed any relevant conflicts of interest.

Author Biographies

G.A.J. Dunselman, Research Institute GROW, Maastricht University Medical Centre, Maastricht

Department of Obstetrics&Gynaecology

C. Becker, University of Oxford, John Radcliff e Hospital, Headington, Oxford

Nuffi eld Department of Obstetrics and Gynaecology

C. Calhaz-Jorge, CHLN/Hospital de Santa Maria, Lisboa

Faculdade de Medicina da Universidade de Lisboa, Human Reproduction Unit, Department of Obstetrics and Gynecology

T. D’hooghe, Department of Obstetrics and Gynecology, Department of Development and Regeneration, Leuven

Отделение акушерства и гинекологии

O. Heikinheimo, Kaёtiloёopisto hospital

Department of Obstetrics and Gynecology

A.W. Horne, MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh

Центр репродуктивного здоровья MRC

A. Prentice, The Rosie Hospital, Cambridge

Department of Obstetrics and Gynaecology

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Published

2014-10-20

How to Cite

Dunselman, G., Vermeulen, N., Becker, C., Calhaz-Jorge, C., D’hooghe, T., De Bie, B., Heikinheimo, O., Horne, A., Kiesel, L., Nap, A., Prentice, A., Saridogan, E., Soriano, D., & Nelen, W. (2014). European society of human reproduction and embryology guideline: management of women with endometriosis. REPRODUCTIVE ENDOCRINOLOGY, (19), 54–67. https://doi.org/10.18370/2309-4117.2014.19.54-67

Issue

No. 19 (2014)

Section

Clinical guidelines

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Copyright (c) 2015 G.A.J. Dunselman, N. Vermeulen, C. Becker, C. Calhaz-Jorge, T. D’hooghe, B. De Bie, O. Heikinheimo, A.W. Horne, L. Kiesel, A. Nap, A. Prentice, E. Saridogan, D. Soriano, W. Nelen

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