Exploring the Relationship between Endometriomas and Infertility

Abstract

Several clinical and epidemiological studies demonstrated an association between endometriosis and infertility. A role in the genesis of infertility may be played by endometriomas, which may interfere with ovulation or damage ovarian tissue. Unlike peritoneal implants, the availability of an accurate noninvasive sonographic diagnosis facilitates the investigation of endometrioma associated infertility. The laparoscopic excision of an endometrioma relieves the ovary from the damage caused by the cyst itself, which may be progressive over time, but at the same time is associated with a detrimental effect on ovarian reserve and with high rates of postoperative endometrioma recurrence. Therefore, the management of endometrioma-related infertility should not be based upon surgery alone, but upon a combination of surgery, with a refinement of the operating technique, long-term oral contraceptive, in vitro fertilization and oocyte cryopreservation.

Accuracy of anogenital distance and anti‐Müllerian hormone in the diagnosis of endometriosis without surgery

“…There are different types of endometriosis, including endometriotic cysts (endometriomas), deep infiltrating endometriosis (DIE), and superficial implants . Endometriosis has a prevalence of approximately 10%, affecting 4%–30% of women of reproductive age, and is usually associated with infertility . Between 30% and 50% of women with endometriosis have reproductive problems; this percentage rises to 70%–80% if pelvic pain is present…”

“…1 Endometriosis has a prevalence of approximately 10%, affecting 4%-30% of women of reproductive age, 2 and is usually associated with infertility. 3 Between 30% and 50% of women with endometriosis have reproductive problems; this percentage rises to 70%-80% if pelvic pain is present. 4 One of the challenges in endometriosis is its early diagnosis among patients with clinical disease.…”

Endometriosis and in vitro fertilisation (Review)

“…Furthermore, primordial follicles are affected due to intense stretching of the cortex, constraining blood flow and causing ischemia. Another hypothesis is the disturbance in ovarian vascularization resulting in lower availability of gonadotropins and decreased stimulation for follicular growth ( 52 ).…”

Management of Endometriosis in the Infertile Patient

“…25,26 The scientific community is now aiming at refining the surgical techniques to temper the injury to the ovarian reserve but, up to now, definite evidence of a reduction in surgical damage to the ovarian reserve has not emerged. 27 Overall, management of infertile women with advanced endometriosis is controversial. Scientific evidence is insufficient to draw a clear indication.…”