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.
Lactational amenorrhea
Although the first post-partum cycle is sometimes anovulatory (reducing the likelihood of becoming pregnant again before having a post-partum period), subsequent cycles are almost always ovulatory and therefore must be considered fertile. For women exclusive breastfeeding ovulation tends to return after their first menses after the 56 days postpartum time period. Supplementing nutritional intake can lead to an earlier return of menses and ovulation then exclusive breastfeeding. Nursing more frequently for a shorter amount of time was shown to be more successful in prolonging amenorrhea then nursing longer but less frequently. The continuing of breastfeeding, while introducing solids after 6 months, to 12 months were shown to have an efficiency rate of 92.6 – 96.3 percent in pregnancy prevention. Because of this some women find that breastfeeding interferes with fertility even after ovulation has resumed.