Endometriosis in women undergoing ovarian tissue transplantation due to premature menopause after gonadotoxic treatment or spontaneous premature ovarian failure

Abstract

Introduction: Cryopreservation of ovarian tissue with subsequent transplantation is an efficient option for restoring fertility in women at risk of premature ovarian failure.The association between infertility and endometriosis is well recognized. Although endometriosis usually ends with the onset of natural or iatrogen menopause due to declining estrogen levels, endometriosis can in rare cases occur after menopause.This study aims to investigate women with premature menopause who were diagnosed with endometriosis during laparoscopy for ovarian tissue transplantation, and to address the questions of how endometriotic lesions after cytotoxic treatment and premature menopause might be explained, whether endometriosis affects pregnancy rates, and whether there is an association between endometriosis and the original cancer.Material and Methods: Seventeen patients who had undergone ovarian tissue transplantation to restore their fertility and who were diagnosed with endometriosis during transplantation were included in this retrospective study. The endometriosis foci were completely removed and ovarian tissue was transplanted into the pelvic peritoneum. Preexisting conditions, use of hormonal preparations, endometriosis stage pain assessment, as well as pregnancy and live birth rate were evaluated. Results:The mean age of the patients was 29.5 ± 6.3 years (range 14-39) at the time of ovarian tissue harvest and 34.6 ± 4.3 years (range 28-40) at transplantation. Prior to transplantation, four patients had taken hormone replacement therapy, four women oral contraceptives and two patients' tamoxifen. Twelve women had stage I endometriosis and five stage II endometrioses according to the rASRM classification. Four patients reported dysmenorrhea. None of the women complained of general pelvic How to cite this article: Lotz L, Dietl A, Hoffmann I, et al. Endometriosis in women undergoing ovarian tissue transplantation due to premature menopause after gonadotoxic treatment or spontaneous premature ovarian failure.

Cuidado Multiprofissional E Biopsicossocial No Contexto Da Saúde Da Mulher Com Endometriose

“…Logo, define-se menopausa precoce como uma falência ovariana precoce (FOP), a qual acomete mulheres antes dos quarenta anos de idade que apresentam amenorreia com duração maior que 4 meses, aumento dos níveis de gonadotrofinas, déficit de estrogênio, anovulação e infertilidade. Além disso, observou-se que a diminuição progressiva na reserva ovariana ocorre devido a perda precoce dos folículos primordiais, que de modo eventual leva a insuficiência ovariana primária (LOTZ et al, 2022).…”