Skip the surgery? Endometriosis may not need treatment before IVF embryo transfer

For years, many doctors have recommended hormonal suppression or even laparoscopic surgery before a frozen embryo transfer (FET) in women with endometriosis — but new research suggests that step may be unnecessary. A study from Weill Cornell Medical College, presented at the ASRM 2026 Scientific Congress, found comparable IVF outcomes between women with and without endometriosis, challenging a long-held clinical assumption.

The retrospective cohort study reviewed 840 FET cycles using euploid embryos, with half performed in women diagnosed with endometriosis. Researchers found no statistically significant differences in live birth rates, miscarriage rates, or biochemical pregnancy rates between the two groups — suggesting the condition doesn't inherently compromise FET success.

By the Numbers:

• Live birth rate: 46.9% (endometriosis) vs. 51.9% (controls) — not significant
• Miscarriage rate: 12.2% vs. 9.2% — not significant
• Biochemical pregnancy rate: 10.7% vs. 15.3% — not significant
• Endometriosis affects 25%–50% of infertile women and 30%–80% of women with pelvic pain
• Average diagnosis delay: 4–11 years

Why it matters: Skipping pre-FET hormonal suppression or surgery could eliminate unnecessary side effects and shorten the path to pregnancy for the millions of women with endometriosis struggling with infertility — a meaningful shift in how clinicians approach this underdiagnosed condition.