Endometrioma, fertility, and assisted reproductive treatments: connecting the dots

Current Opinion in Obstetrics & Gynecology
Gustavo N Cecchino, Juan A García-Velasco

Abstract

Surgery has traditionally been the primary treatment option for endometriosis-related infertility of any phenotype. However, advances and refinements of assisted reproductive technologies (ART) permit a more conservative approach in many scenarios. This review summarizes the latest findings in the field of reproductive medicine, which have supported a paradigm shift towards more conservative management of ovarian endometrioma. The presence of ovarian endometrioma per se is likely to impair ovarian reserve and alter ovarian functional anatomy. Conventional laparoscopic surgery is associated with significant risk of additional damage, and less invasive treatment approaches require further evaluation. With regard to infertile women with ovarian endometrioma who are scheduled for ART treatment, current data indicate that prior surgical intervention does not improve ART outcomes, and that controlled ovarian hyperstimulation (COH) does not affect quality of life or pain symptoms. Reproductive medicine physicians frequently encounter patients with ovarian endometrioma. The current evidence does not support the postponement of infertility treatment in favour of surgery, except in cases with severe symptoms or to improve follicle access...Continue Reading

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Citations

Oct 23, 2019·Journal of Ovarian Research·Yu LiangShuyu Wang
Jan 25, 2022·Journal of Assisted Reproduction and Genetics·Mira H KheilGaby Moawad

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