Fertility Preservation in Women With Endometriosis

Llarena, Natalia C.; Flyckt, Rebecca

doi:10.1177/1179558119873386

Cited by 44 publications

(30 citation statements)

References 167 publications

(163 reference statements)

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“…CD10 immunohistochemistry can be of additional value in diagnosing endometriosis in difficult cases where CD10 stains the endometrial stroma. 4,5,8,11 Majority of cases in the present study showed the absence of follicles with the presence of primordial follicles in 22% of cases. These findings suggest that the capsule is the invaginated cortex itself and hence their removal affects the ovarian stroma.…”

Section: Cortical Invagination Cysts Surface Inclusion Cyst-related Endometriotic Cystsmentioning

confidence: 45%

“…Endometriosis is an important gynecologic disorder with multifactorial causes, primarily affecting women during the pouch of Douglas, pelvic peritoneum and uterosacral ligaments. 4,5 Clinically patients may be asymptomatic or may present with disabling pelvic pain, infertility, or adnexal masses. 1,5,6 Occasionally these can enlarge to present as huge abdominal masses which can mimic ovarian malignancy.…”

Section: Introductionmentioning

confidence: 99%

“…4,5 Clinically patients may be asymptomatic or may present with disabling pelvic pain, infertility, or adnexal masses. 1,5,6 Occasionally these can enlarge to present as huge abdominal masses which can mimic ovarian malignancy. Cyst aspiration, fenestration and ablation of cyst wall are some the commonly performed surgical procedures.…”

Section: Introductionmentioning

confidence: 99%

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A clinicopathological study of ovarian endometriotic cysts

Shivamurthy

Gurumurthy²

2021

IJPO

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Endometriosis is an important gynecologic disorder with multifactorial causes, primarily affecting women during their reproductive years. Pathologically, it is the result of functional endometrium located outside the uterus which may vary from microscopic endometriotic implants to large cysts. Endometriotic cysts and infertility is a well-known association. Some patients are asymptomatic while others present with disabling pelvic pain, infertility, or adnexal masses. Cyst aspiration, fenestration and ablation of cyst wall are commonly performed surgical procedures. Excision of the cyst wall is an accepted surgical treatment owing to the low recurrence rates. A total of 35 patients who underwent ovarian cystectomy for endometriotic cysts between January 2019 and December 2020 were retrospectively identified. The clinical findings, gross and histopathological features were noted in each case. Microscopically, the presence or absence of ovarian tissue adjacent to the cyst wall was evaluated. If ovarian tissue was present, the morphologic characteristics were graded on a semi-quantitative scale of 0-4 as described by Muzii et al. The age group of patients ranged between 22-28yrs. Right side cysts accounted for the majority, however 6 cases had bilateral endometriotic cysts. Majority of patients presented with primary infertility (46.2%). The maximum weight recorded for these cysts was 35gm, size ranging between 4.5 to 18cm and median thickness of the cyst wall being 0.7cm. 68% of the cysts showed a lining epithelium, few showing atypia and oncocytic change. Fibrosis and hemosiderin laden macrophages were present in more than 70% of cases and endometrial glands and stroma in more than 50%. Inflammation when present was predominantly lymphocytic. On evaluation of the ovarian tissue, 42.8% of cases showed no follicles and the rest showing grades ranging from 1 to 4, with grade 1 accounting for majority. The present study further emphasizes endometriosis to be an important cause of primary infertility which needs to be recognized and treated appropriately. Recognition of these cysts on histopathological examination can be challenging at times when endometrial stroma is scant and in cases of tubo-ovarian masses where these lesions could mimic malignancy. The excision of endometriotic cyst wall may cause loss of functional ovarian tissue in patients with primary infertility and thus could effect the response to ovarian stimulation, ocyte recovery, implantation and fertilization rates in these patients.

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Section: Cortical Invagination Cysts Surface Inclusion Cyst-related Endometriotic Cystsmentioning

confidence: 45%

Section: Introductionmentioning

confidence: 99%

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A clinicopathological study of ovarian endometriotic cysts

Shivamurthy

Gurumurthy²

2021

IJPO

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“…Therefore, an alternative approach is warranted for these patients predisposed to a low ovarian reserve. The excision of excess ovarian tissue or damage to the ovarian vascular bed may cause iatrogenic ovarian injury (23)(24)(25). Moreover, previous studies have demonstrated that laparoscopic ovarian cystectomy for endometriomas decreases serum AMH levels at 6 months after surgery (26,27).…”

Section: Discussionmentioning

confidence: 99%

Therapeutic Efficacy of Catheter-directed Ethanol Sclerotherapy and Its Impact on Ovarian Reserve in Patients with Ovarian Endometrioma at Risk of Decreased Ovarian Reserve: A Preliminary Study

Lee

Ahn

Kim

et al. 2022

Journal of Minimally Invasive Gynecology

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…Our study indicated that women with endometriosis were more likely to develop infertility. Endometriosis often causes infertility (30%-50% of affected women), which may increase infertility interventions, particularly IVF treatment and the risk of TOA [13][14].…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics, treatment status and complications in women with tube ovarian abscess and endometriosis: a retrospective study

Zhao

Chang

et al. 2020

Preprint

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Background: The aim of our present study was to investigate the clinical characteristics, treatment status and complications in women with endometriosis and tube ovarian abscess (TOA) to determine the possible association between TOA and endometriosis.Methods: Medical records were used to analyze the clinical characteristics, treatment and complications. Twenty women who were diagnosed with TOA with endometriosis were compared with 93 women diagnosed as having TOA without endometriosis between January, 2008 and December, 2018. Statistical analysis was performed using SPSS Version 20.Results: In this study, TOA patients with endometriosis were significantly more likely to have a lower age range (20–39years) than the non-endometriosis group (11/20 (55.0%) vs 27/93 (29.0%), p=0.036). In addition, TOA patients with endometriosis were associated with a significantly lower rate of parity (11/20 (55.0%) vs 75/93 (80.6%), p=0.021), higher rates of infertility (8/20(40%) vs 0/93(0%), p=0.000) and a significantly lower incidence of elevated blood platelet counts (5/20 (25%) vs 43/93 (53.8%), p = 0.026). Furthermore, women with endometriosis had greater blood loss (347±445.77 vs 204.67±289.46, p= 0.014) and an increased complication rate (3/20(15%) vs 0/93(0%), p = 0.000). Among the 3 patients who had complications in the endometriosis group, 2 patients had septic shock and 1 patient had intestinal obstruction. And 1 case who had septic shock followed by IVF treatment. There was no significance difference on other factors.Conclusions: The present study indicated that endometriosis did not increase the difficulty and time of treatment in patients with TOA, but increased bleeding during surgery and serious complications. It is suggested that doctors should pay more attention to postoperative treatment and nursing in women with TOA and endometriosis, especially those who have a history of recent infertility treatment and related procedures.

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Fertility Preservation in Women With Endometriosis

Cited by 44 publications

References 167 publications

A clinicopathological study of ovarian endometriotic cysts

A clinicopathological study of ovarian endometriotic cysts

Therapeutic Efficacy of Catheter-directed Ethanol Sclerotherapy and Its Impact on Ovarian Reserve in Patients with Ovarian Endometrioma at Risk of Decreased Ovarian Reserve: A Preliminary Study

Clinical characteristics, treatment status and complications in women with tube ovarian abscess and endometriosis: a retrospective study

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