Endometriosis is combined with infertility in 40-50% of patients. For these patients, a comprehensive infertility examination is first performed according to the infertility treatment pathway to exclude other infertility factors. 1. Drug treatment Currently, GnRHa is mostly used for treatment. However, GnRHa alone can inhibit ovulation, so it is not advocated to be used alone and is mostly used in the pre-treatment of IVF. A large number of studies have concluded that the application of GnRHa treatment for 2 to 6 months before IVF can increase the rate of high quality embryos, the rate of bed placement and reduce the rate of miscarriage, and can obtain a similar clinical pregnancy rate and a lower miscarriage rate than patients with tubal factors alone. the pregnancy rate is 4 times higher with GnRHa treatment than with no treatment. 2.Surgical treatment Surgical removal of endometriosis lesions from the pelvic and abdominal surfaces may improve the toxic environment of the pelvis, with a pregnancy rate of 10-30% one year after surgery. However, it can lead to an irreversible decrease in ovarian reserve, so caution should be exercised in infertile patients. Patients requiring surgery should be fully evaluated for ovarian reserve and possible damage to the ovaries from surgery and patient tolerance before recommending it to patients. The type and stage of endometriosis and the EFI (Endometriosis Fertility Index) score should be evaluated to assess the severity of the endometriosis lesion and to assess the prognosis of infertility, and the patient should be given fertility instructions based on the EFI score. Intraoperative tubal lavage can be performed at the same time to understand the patency of the fallopian tubes; hysteroscopy can also be performed at the same time to understand the condition of the uterine cavity. For young patients with mild to moderate endometriosis and high EFI score, natural pregnancy can be expected for 6 months after surgery and fertility guidance should be given; for those with low EFI score and high risk factors (age over 35 years, infertility for more than 3 years, especially primary infertility; severe endometriosis, pelvic adhesions, incomplete excision of lesions; incompetent fallopian tubes), assisted reproductive technology should be actively performed to help conception. GnRHa pretreatment should be used before assisted conception, usually applied for 3-6 months. 3. IVF treatment IVF treatment has become a major method to obtain pregnancy in patients with endometriosis, especially in patients with moderate to severe endometriosis (stage III and IV) and those with recurrent endometriosis or reduced ovarian reserve function and those who are still infertile after surgery. Domestic and international studies have reported that the success rate of IVF in patients with endometriosis is slightly lower than that of patients with tubal factors alone, but there is no statistical difference. 4. Effect of surgery on pregnancy The ovarian endometriosis cyst debridement surgery inevitably causes loss of ovarian tissues, destruction of ovarian function by endometriosis itself and inflammatory reaction to ovarian trauma after surgery, all of which can result in a decrease in ovarian reserve function after surgery. Therefore, before laparoscopic surgery in infertile patients, the impact of surgery on ovarian reserve function should be thoroughly evaluated and considered. Repeat surgery is not recommended for recurrent cysts; studies have shown that the pregnancy rate after reoperation is only 1/2 that of the initial treatment, so first cyst puncture and assisted reproductive technology treatment are recommended. If the pain symptoms are severe, the cyst is gradually increasing in size, puncture is ineffective or impossible or assisted reproductive technology treatment has repeatedly failed, surgery should be performed, but surgery does not significantly improve the postoperative pregnancy rate. 5. Surgery for DIE (deep nodular type) has no significant effect on the pregnancy rate Therefore, in vitro fertilization-embryo transfer (IVF-ET) is preferred for patients with DIE combined with infertility who have insignificant pain symptoms, and surgery is used as the second-line treatment for IVF-ET failure. 6. Treatment of infertility in adenomyosis Adenomyosis is an independent factor affecting postoperative pregnancy. For diffuse adenomyosis, it should be treated with medication first to reduce the size of the uterus followed by natural pregnancy or assisted reproductive technology; if medication is ineffective, wedge hysterectomy is feasible. For limited adenomyoma, surgical excision is feasible. Wedge resection for adenomyosis and adenomyomectomy cannot completely remove the lesion, and the recurrence rate is high after surgery, and there is a risk of uterine rupture in pregnancy after surgery.