Subfertility is associated with endometriosis though precise mechanisms have been elusive.
Surgery, to remove gross adhesions, appears to be useful in some cases. In one large study of 579 patients (Adamson, 1993) laparoscopic surgery was found to be better than other forms of treatment with pregnancy rates of 40-60% at two years for different stages of disease. Pregnancy rates are 10% lower for medical treatment.
In the uterine denervation view, if there are injuries to uterine nerves then several other mechanisms may require consideration. There are clearly transport difficulties for egg and sperm if there is loss of uterotubal polarity because of injuries to pelvic nerves. IVF techniques may circumvent some of the transport problems by placing the gametes beyond the injured nerves.