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.
Human reproductive ecology
Fertility is influenced by fecundity, but has additional factors that can increase or decrease an individual's lifetime reproductive success. The inter-birth interval, the amount of time between a woman's births, impacts a woman's total fertility. This amount of time varies cross-culturally, as well as varies with different environmental constraints. Many cultures practice conscious birth spacing to adhere to the desired length of time between pregnancies, or desired number of children. Environmental concerns like fetal loss, lack of resource access, and disease may all impact fertility for females or males.