Endometriosis is a chronic condition characterized by the presence of endometrial-like tissue outside the uterus, leading to chronic inflammation, scar tissue, and adhesions. It affects 6–10% of women, with higher prevalence in those experiencing pain, infertility, or both. Endometriosis is associated with pelvic pain, dysmenorrhea, and dyspareunia, and is a significant cause of infertility, with 25–50% of infertile women having endometriosis. The condition is linked to various factors, including distorted pelvic anatomy, endocrine and ovulatory abnormalities, and altered peritoneal function. While endometriosis is often asymptomatic, it can significantly impact a woman's quality of life. Current treatments for endometriosis focus on symptom management rather than curing the disease. Medical treatments can relieve pain but lack evidence of improving fertility. Surgical interventions, such as laparoscopic excision of endometriotic implants, may improve fertility in mild to moderate cases, but there is no conclusive evidence that combined medical-surgical treatments significantly enhance fertility. In severe cases, a multidisciplinary approach is necessary. Assisted reproductive technologies, such as in vitro fertilization (IVF), are often recommended for women with advanced endometriosis. Endometriosis can affect uterine contractility, which is crucial for embryo implantation. Abnormal uterine contractions may interfere with the implantation process. Endometriosis-associated infertility is complex, with multiple potential mechanisms, including altered endometrial receptivity, ovulatory dysfunction, and peritoneal inflammation. The treatment of endometriosis-related infertility often involves a combination of surgical and assisted reproductive technologies. While IVF is effective, it may not always be the first-line treatment, especially in cases where surgical intervention is appropriate. The management of endometriosis requires a personalized approach, considering the patient's symptoms, age, and fertility goals. Endometriosis should be viewed as a chronic condition requiring long-term management. While there is no consensus on the optimal treatment for mild endometriosis, radical surgery is recommended for more severe cases. Overall, a combination of surgical and assisted reproductive technologies is often the most effective approach for managing endometriosis-related infertility.Endometriosis is a chronic condition characterized by the presence of endometrial-like tissue outside the uterus, leading to chronic inflammation, scar tissue, and adhesions. It affects 6–10% of women, with higher prevalence in those experiencing pain, infertility, or both. Endometriosis is associated with pelvic pain, dysmenorrhea, and dyspareunia, and is a significant cause of infertility, with 25–50% of infertile women having endometriosis. The condition is linked to various factors, including distorted pelvic anatomy, endocrine and ovulatory abnormalities, and altered peritoneal function. While endometriosis is often asymptomatic, it can significantly impact a woman's quality of life. Current treatments for endometriosis focus on symptom management rather than curing the disease. Medical treatments can relieve pain but lack evidence of improving fertility. Surgical interventions, such as laparoscopic excision of endometriotic implants, may improve fertility in mild to moderate cases, but there is no conclusive evidence that combined medical-surgical treatments significantly enhance fertility. In severe cases, a multidisciplinary approach is necessary. Assisted reproductive technologies, such as in vitro fertilization (IVF), are often recommended for women with advanced endometriosis. Endometriosis can affect uterine contractility, which is crucial for embryo implantation. Abnormal uterine contractions may interfere with the implantation process. Endometriosis-associated infertility is complex, with multiple potential mechanisms, including altered endometrial receptivity, ovulatory dysfunction, and peritoneal inflammation. The treatment of endometriosis-related infertility often involves a combination of surgical and assisted reproductive technologies. While IVF is effective, it may not always be the first-line treatment, especially in cases where surgical intervention is appropriate. The management of endometriosis requires a personalized approach, considering the patient's symptoms, age, and fertility goals. Endometriosis should be viewed as a chronic condition requiring long-term management. While there is no consensus on the optimal treatment for mild endometriosis, radical surgery is recommended for more severe cases. Overall, a combination of surgical and assisted reproductive technologies is often the most effective approach for managing endometriosis-related infertility.