Endometriosis and infertility
Surgery is more effective for infertility than medicinal intervention in endometriosis. One study has shown that surgical treatment of endometriosis approximately doubles the fecundity (pregnancy rate). The use of medical suppression after surgery for minimal/mild endometriosis has not shown benefits for patients with infertility. Use of fertility medication that stimulates ovulation (clomiphene citrate, gonadotropins) combined with intrauterine insemination (IUI) enhances fertility in these patients.
Health in Australia
In 2011, endometriosis was estimated to affect 550,000 women and girls in Australia, with estimated direct costs fof $6 billion per annum for medical and surgical treatments of adult women and $600 million per annum for medical and surgical treatments of girls. Between the ages of 15 to 49 years, approximately 1 in 10 women are affected by it, a higher incidence than conditions such as breast cancer, prostate cancer, diabetes and AIDS combined within that age range. Working women are estimated to lose 11 hours per week due to absenteeism and presenteeism. In addition, there are the indirect costs and the general loss of quality of life due to the debilitating pain. Such indirect costs include welfare payments for disability and unemployment, expenditure on complementary medication and therapies, and the medical costs of treating consequential issues of mental health and infertility caused by endometriosis. Endometriosis usually first presents symptoms during adolescence but there is an average of 8 years from first symptoms to diagnosis, due to parents and general practitioners "discrediting" the pelvic pain as being a "normal" aspect of the menstrual cycle, while employed women encounter negativity by employers towards women perceived to have menstrual irregularities.