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Endometriosis decreases the fertility of an individual, although many women conceive in spite of this complication. Fertility in normal women declines rapidly after 35 years of age. Pregnancy does not have a deleterious effect on endometriosis, for it is likely to remain quiescent or even undergo some regression. The progress of endometriosis is dependent on ovarian function, so that any measure that suppresses gonadal activity will affect the endometriosis favorably. Thus, the steroid hormones, estrogens and androgens, inhibit the function of the anterior lobe of the pituitary and suppress ovarian function. A diagnosis of endometriosis is usually made on pelvic examination, which will reveal an enlarged adherent ovary on one or both sides and thickening and fixation in the cul-desac and rectovaginal septum. In classic cases bluish cysts can often be visualized in the posterior vaginal cul-de-sac with the aid of a speculum. A curettage provides no information concerning endometriosis,
ENDOMETRIOSIS AND INFERTILITY. JAMA. 1956;162(6):575. doi:10.1001/jama.1956.02970230047014