The treatment of pelvic factor infertility involving pelvic adhesions and endometriosis usually is aggressive (minimally invasive) surgery with an experienced fertility surgeon. If the couple does not become pregnant following an aggressive attempt to normalize the pelvic anatomy (surgically), then treatment options include (a) overwhelming the existing barrier with COH/IUI or (b) bypassing the pelvic barrier with In Vitro Fertilization.
Success with COH/IUI depends on the (existing) extent of damage to the pelvic organs. The pelvic damage can often be improved (minimized) with surgery.
With COH/IUI the woman (hopefully) will produce several mature eggs (more targets for the sperm) and the IUI brings the sperm into close approximation to these mature eggs. When COH/IUI is selected to treat infertility in the presence of pelvic factor abnormalities, it is important to realize that the (pregnancy) success rate is (maximally) only about 20-30% per cycle. A normal fertile couple has a (pregnancy) success rate of about 20-25% per cycle (of trying).
Therefore, the infertility specialist usually recommends 3-6 cycles of COH/IUI to (cumulatively) achieve optimal success with this treatment option. If the damage to the pelvis has been severe, or the couple does not become pregnant with COH/IUI, then In Vitro Fertilization is often suggested (required).