Ovarian Endometrioma: Surgery and Fertility Preservation

Rombauts, Luk

doi:10.1002/9781444398519.ch47

Cited by 2 publications

(2 citation statements)

References 65 publications

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“…The management of endometriomas in the context of infertility has recently been the subject of much debate, especially in view of the growing success of in vitro fertilization (52). According to Rombauts (53), the two questions at the center of the debate are whether surgery still has a place, and if so, which procedure gives the best results. Shervin et al (54) claimed that in advanced cases associated with deep endometriosis and infertility, fine excision and stripping of the endometrioma along with radical resection of the deep lesions improves fecundity without any significant adverse effect when compared to patients with intact ovaries.…”

Section: Hazards To Future Reproductive Healthmentioning

confidence: 99%

Endometrioma in Adolescents and Future Reproductive Health

Brosens

Benagiano

2017

Journal of Endometriosis and Pelvic Pain Disorders

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about the "progressive nature" of early-onset disease was not shared by Evers who argued in an Editorial that in the seven published trials where laparoscopy was performed before and after a period without treatment, in 71% of the cases the disease did not progress (2). Two considerations are in order when analyzing Evers' conclusion. On the one hand, it is clearly impossible to predict in which cases endometriosis will progress; on the other, the investigations upon which Evers based his conclusions were conducted in adult women and, over the last few years, we have argued that there is strong indirect evidence that the adult and the pre-pubertal and adolescent variants of endometriosis may have a different origin and phenotype (3). According to this hypothesis, early-onset disease traces its roots in the retrograde fetal endometrial shedding occurring in approximately 5% of neonates at the time of birth that is manifested by a well-documented, but neglected phenomenon called "neonatal menstruation" (4, 5). The visible bleeding with retrograde endometrial shedding has the ability to affect pelvic organs and become the source of disorders that may develop later in life and pose a risk for the future reproductive health of the adolescent (3, 6-8). We believe that the theory of a different origin of pre-pubertal or adolescent and adult forms of endometriosis is well founded, thanks to a series of investigations carried out half a century ago. At the

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Section: Hazards To Future Reproductive Healthmentioning

confidence: 99%

Endometrioma in Adolescents and Future Reproductive Health

Brosens

Benagiano

2017

Journal of Endometriosis and Pelvic Pain Disorders

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“…A technique for fertility preservation that has recently gained attention is represented by oocyte cryopreservation [66]. Oocyte retrieval, in cases of bilateral endometriomas, may be performed before surgery, due to the risk of ovarian dysfunction associated with iatrogenic trauma to both gonads [46].…”

Section: Fertility Preservationmentioning

confidence: 99%

Exploring the Relationship between Endometriomas and Infertility

Berlanda

Alberico

Barbara

et al. 2015

Womens Health (Lond Engl)

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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.

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Ovarian Endometrioma: Surgery and Fertility Preservation

Cited by 2 publications

References 65 publications

Endometrioma in Adolescents and Future Reproductive Health

Endometrioma in Adolescents and Future Reproductive Health

Exploring the Relationship between Endometriomas and Infertility

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