What is the impact of early surgical intervention compared to conservative (medical) management on fertility outcomes in patients diagnosed with moderate to severe endometriosis, particularly in terms of pregnancy rates, time to conception, ovarian reserve, recurrence of disease, and overall reproductive success.
My sister was diagnosed with severe endometriosis in her late 20s. The doctors advised surgery early, but she initially went for hormonal therapy. After a couple of years of trying to conceive without success, she eventually underwent laparoscopic surgery. Post-surgery, she was able to conceive within a year. From what we understood, the surgery helped by clearing adhesions, but the delay in intervention may have reduced her natural fertility window slightly.