{"paper_id":"77bcbfbd-78c6-43a3-a94a-89ed6d7164d3","body_text":"Abstract\nBackground\nEndometriosis is a common cause for infertility. Decreased ovarian reserve due to pathology or surgical management can reduce the chances of natural pregnancy and limit the effectiveness of controlled ovarian stimulation during fertility treatment. Cryopreservation of oocytes or ovarian cortex prior to surgery or before loss of follicular capital is a strategy to preserve fecundity.\nMethods\nAn online survey was sent to reproductive specialists and gynecological surgeons representing major centers of reproductive medicine in Europe to investigate current fertility preservation practices for endometriosis patients.\nResults\nOf 58 responses, 45 (77.6%) in 11/13 countries reported the existence of endometriosis management guidelines, of which 37/45 (82.2%) included treatment recommendations for infertile patients. Most centers (51.7%) reserved fertility counselling for severe endometriosis (large endometriomas with or without deep endometriosis) while 15.5% of centers did not offer fertility preservation for endometriosis.\nConclusions\nTo address non-uniformity in available guidelines and the diversity in fertility preservation practices, we propose an algorithm for managing patients with severe endometriosis most likely to be impacted by reduced ovarian reserve. Improved awareness about the possibilities of fertility preservation and clear communication between gynaecological surgeons and reproductive medicine specialists is mandatory to address the unmet clinical need of preventing infertility in women with endometriosis.\nAccess this article\nWe’re sorry, something doesn't seem to be working properly.\nPlease try refreshing the page. If that doesn't work, please contact support so we can address the problem.\nSimilar content being viewed by others\nData availability\nThis was not an interventional study and no new patient data were created or analyzed. Data sharing is not applicable to this article.\nAbbreviations\n- ACOG:\n-\nAmerican college of obstetricians and gynecologists\n- AFC:\n-\nAntral follicular count\n- AMH:\n-\nAnti-müllerian hormone\n- ART:\n-\nAssisted reproductive techniques\n- ASRM:\n-\nAmerican society for reproductive medicine\n- AWMF:\n-\nArbeitsgemeinschaft der wissenschaftlichen medizinischen fachgesellschaften\n- CNGOF:\n-\nCollège national des gynécologues et obstétricien français\n- DGGG:\n-\nDeutsche gesellschaft für gynäkologie und geburtshilfe\n- ESHRE:\n-\nEuropean society of human reproduction and embryology\n- FertiPROTEKT:\n-\nNetwork of fertility preservation centres in German-speaking countries\n- FIGO:\n-\nInternational federation of gynecology and obstetrics\n- FP:\n-\nfertility preservation\n- FSH:\n-\nFollicle-stimulating hormone\n- GnRH:\n-\nGonadotropin-releasing hormone\n- IVF:\n-\nIn vitro fertilization\n- NICE:\n-\nNational institute for health and care\n- SEF:\n-\nSociedad española de fertilidad\n- SIGO:\n-\nItalian society of gynecology and obstetrics\n- SOGC:\n-\nSociety of obstetricians and gynaecologists of Canada\n- WES:\n-\nWorld endometriosis society\nReferences\nDonnez J, Dolmans MM (2017) Fertility preservation in women. 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Arch Gynecol Obstet 303(5):1353–1361. https://doi.org/10.1007/s00404-020-05871-1\nBerlanda N, Alio W, Angioni S et al (2022) Impact of endometriosis on obstetric outcome after natural conception: a multicenter Italian study. Arch Gynecol Obstet 305(1):149–157. https://doi.org/10.1007/s00404-021-06243-z\nAcknowledgements\nEditorial support and assistance in the preparation of figures was provided by Joanne Fitz-Gerald and Jonathan A C Lee at FourWave Medical Communications, the funding for which was provided by PregLem S.A./Gedeon Richter.\nFunding\nThe survey platform was funded by PregLem (PregLem SA, Route de Frontenex 41A, 1207 Geneva, Switzerland) [a member of the Gedeon Richter group, Budapest, Hungary] and dispersed through the ORBIS-network across Europe.\nAuthor information\nAuthors and Affiliations\nContributions\nNS and JV conceived of the presented idea, developed the survey and performed the computations. NS and MM verified the analytical methods. All authors helped to shape the research, disseminate the survey and contributed to the analysis and interpretation of the results. NS took the lead in writing the manuscript and all authors provided critical feedback and contributed to the final manuscript. All authors have read and agreed to the published version of the manuscript.\nCorresponding author\nEthics declarations\nConflict of interest\nMM is employed by the funder of this survey, PregLem S.A., and contributed to the design of the survey and reviewed the manuscript. The other authors declare no conflicts of interest.\nEthical approval\nNot applicable.\nConsent to participate\nNot applicable.\nConsent for publication\nNot applicable.\nAdditional information\nPublisher's Note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nSupplementary Information\nBelow is the link to the electronic supplementary material.\nRights and permissions\nAbout this article\nCite this article\nSänger, N., Menabrito, M., Di Spiezo Sardo, A. et al. Fertility preservation counselling for women with endometriosis: a European online survey. Arch Gynecol Obstet 307, 73–85 (2023). https://doi.org/10.1007/s00404-022-06616-y\nReceived:\nAccepted:\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1007/s00404-022-06616-y","source_license":"CC0","license_restricted":false}