The Conservative Surgical Treatment of Endometriosis: Evaluation of Pregnancy Success with Respect to the Extent of Disease as Categorized Using Contemporary Classification Systems

Endometriosis, especially mild disease: a risk factor for miscarriages

“…The revised classification of the American Society for Reproductive Medicine (rASRM) (33) was used to categorize the endometriosis into the four stages. This staging was applied as it was initially developed to define chances for pregnancy (34). Additionally, the lesions were classified into three phenotypes: superficial peritoneal endometriosis (SUP), ovarian endometriosis (OMA), and deep infiltrating endometriosis (DIE), as previously described by other investigators (35,36).…”

The Impact of Endometrioma and Its Surgical Treatment on Ovarian Reserve and Reproductive Performance

“…Ovarian endometriomas have been shown to be associated with increased rates of infertility, particularly if they are large (>3 cm) or have ruptured [ 16 ]. In a recent longitudinal cohort study, we have found a signifi cantly reduced spontaneous pregnancy rate (48 %) in patients with untreated endometriomas seeking fertility compared with a group of healthy controls (Fig 5.2 ) [ 17 ].…”

Controversies in the Management of Endometrioma

“…Studies utilizing infertile patients as their own historical controls suggest, but do not prove, improvement in fertility after surgery. 18 One pseudorandomized study comparing resection of endometrioma through laparoscopy versus laparotomy in women with a mean of 32 months of infertility found equivalent chances of pregnancy by 24 months after surgery in both groups (53% and 47%, respectively). 53 However, a recent observational study of 68 women found similar rates of spontaneous pregnancy before and after surgery for ovarian endometrioma (50% and 48%, respectively), with rates in both groups significantly lower than for agematched controls without history of endometriosis or ovarian surgery.…”