Which ovarian stimulation protocols are best for endometriosis?

In patients with endometriosis, many fertility teams favor an antagonist stimulation protocol because it offers tight control over timing and can support a GnRH-agonist trigger, which may lower the risk of ovarian hyperstimulation while keeping the cycle more predictable. The “best” protocol still depends on your ovarian reserve, prior response to stimulation, pain/inflammation symptoms, and whether endometriomas are present.

Some approaches aim to limit high estrogen exposure during stimulation, such as adding letrozole or using progestin-primed stimulation in select cases. If progesterone rises early or the uterine lining isn’t ideal, your team may recommend freezing embryos and planning transfer in a later cycle rather than proceeding fresh. In a consultation, we can review your endometriosis history alongside your fertility goals and coordinate with your reproductive endocrinologist on a protocol tailored to your situation.