In patients with severe endometriosis, IVF represents an effective treatment option for infertility, as a complement to surgery.We advocate early IVF in cases of female factor infertility with endometriosis due to risk of deteriorating ovarian reserves with increasing age of the patient.We compared all cases of female factor infertility with endometriosis that were treated with IVF at our specialty centers between January 2009 and April 2012 with age matched controls (patients without endometriosis undergoing IVF) to assess the impact of endometriosis on required dosage of stimulating Gonadotropins, no of oocytes retrieved and outcome of IVE We found that patients with endometriosis required a relatively higher dose of Gonadotropins for adequate ovarian stimulation, yet was associated with a comparatively lesser no of Oocytes retrieved and a lower pregnancy rate.Therefore, we recommend an early and more aggressive management of infertility in patients with endometriosis because of the risk of reduced ovarian reserve and lower pregnancy rate.The treating physicians should also be open to consider an earlier IVF intervention in this group of patients.