{"paper_id":"a63049dd-ba32-4c17-b08d-566ebe529270","body_text":"Oct 16, 2024\nEndometrioma\nDOI\nhttps://dx.doi.org/10.17504/protocols.io.kqdg3227pv25/v1\nAlexandraIoannidou,NikolaosMachairiotis,SofoklisStavros,AnastasiosPotiris,TheodorosKarampitsakos,\nAthanasiosPantelis,PetrosDrakakis\nThird Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens Medical\nSchool, Attikon Hospital,1 Rimini, 124 62 Athens, Greece\nAthanasios Pantelis\nAthens Medical Group, Psychiko Clinic\nCreate & collaborate more with a free account\nEdit and publish protocols, collaborate in communities, share insights through comments, and\ntrack progress with run records.\nCreate free account\n1 1 1 1 1\n1 1\n1\nDOI: https://dx.doi.org/10.17504/protocols.io.kqdg3227pv25/v1\nProtocolCitation: Alexandra Ioannidou, Nikolaos Machairiotis, Sofoklis Stavros, Anastasios Potiris, Theodoros Karampitsakos,\nAthanasios Pantelis, Petros Drakakis2024. Endometrioma.protocols.io\nhttps://dx.doi.org/10.17504/protocols.io.kqdg3227pv25/v1\nManuscript citation:\nNo published manuscript\nprotocols.io | https://dx.doi.org/10.17504/protocols.io.kqdg3227pv25/v1 October 16, 2024 1/11\n\nLicense: This is an open access  protocol  distributed under the terms of the  Creative Commons Attribution License,  which\npermits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited\nProtocol status:Working\nWe use this protocol and it's working\nCreated:June 02, 2024\nLast Modified:October 16, 2024\nProtocol  Integer ID:101092\nKeywords: endometriosis, endometrioma, anti-mullerian hormone, laparoscopic cystectomy, CO2 laser vaporization, plasma\nenergy ablation, sclerotherapy, GnRH agonist treatment, assisted reproduction treatment, surgical intervention for\nendometrioma, endometrioma, endometriosi, endometrioma background, endometrial tissue, presence of endometrial tissue,\ninfertility parameter, uterus, laparoscopic cystectomy, ovarian reserve, correlation with infertility parameter, fertility, information\non surgical intervention, pregnancy rate, surgical intervention\nAbstract\nBackground:\nEndometriosis is characterized by the presence of endometrial tissue outside\nthe uterus. Beyond medical treatment, surgical intervention is also a viable\nconsideration. However, current guidelines do not clearly indicate whether\nlaparoscopic cystectomy, ablative methods CO2 laser vaporization, plasma\nenergy), or sclerotherapy is the preferred option. Methods: We conducted\nsearches in two databases PubMed, Europe PMC) to retrieve articles containing\nthe keywords ‘surgical intervention for Endometrioma, ovarian reserve,\npregnancy rates, fertilityʼ, published between January 1, 2000, and December\n31, 2023. We will include articles presenting information on surgical intervention\nfor endometrioma and its correlation with infertility parameters. Articles\ndescribing conservative treatment will be excluded. Data will be extracted by two\nauthors using predefined criteria. \nImage Attribution\nOne figure with flow diagram including studies' selection.\nprotocols.io | https://dx.doi.org/10.17504/protocols.io.kqdg3227pv25/v1 October 16, 2024 2/11\n\nGuidelines\nAccording to PRISMA 2020 checklist.\nTITLE\nThe report is identified as a systematic review. \nABSTRACT\nThis research is written according to PRISMA 2020 checklist for Abstracts.\nTitle: The report is identified as a systematic review. \nBackground: An explicit statement of the main objective the review addresses is provided.\nMethods: The inclusion and exclusion criteria for the review are specified. The information sources (e.g.\ndatabases, registers) used to identify studies and the date when each was last searched are specified. The\nmethods used to assess risk of bias in the included studies are specified. \nINTRODUCTION\nThe rationale for the review is described in the context of existing knowledge. An explicit statement of the\nobjective the review addresses is provided.\nprotocols.io | https://dx.doi.org/10.17504/protocols.io.kqdg3227pv25/v1 October 16, 2024 3/11\n\nMaterials\nThe conduct of this systematic review will adhere to the guidelines set by the Preferred Reporting Items for\nReviews and Meta-Analyses PRISMA Statement. \nData sources and Search Strategy\nSearch will be conducted across two databases—PubMed and Europe PMC—to collect articles\ncontaining the keywords ‘surgical intervention for endometrioma, ovarian reserve, pregnancy rates, fertilityʼ\npublished between January 1, 2000, and October 30, 2023.\nEligibility Criteria for Articles of Inclusion \nThe articles will be limited to those written in English and only full research articles will be included. Abstracts\npresented in scientific meetings will be excluded as well as review articles. Only articles presenting information\nabout surgical intervention for endometrioma and their correlation with infertility parameters will be included.\nAny articles describing conservative treatment for endometrioma will be also excluded. To avoid bias, articles\nthat refer to the combined treatment of endometrioma will be also considered. \nData Extraction\nSpecific data will be extracted from each publication in duplicate, including publication date, authorship,\nstudied population, methodologies employed, criteria for inclusion or exclusion I/E, sample type, and primary\noutcome measures.\nSafety warnings\nNone to declare.\nEthics statement\nNot applicable.\nprotocols.io | https://dx.doi.org/10.17504/protocols.io.kqdg3227pv25/v1 October 16, 2024 4/11\n\nIntroduction\n1 Introduction\nEndometriosis, growing outside the uterus, takes various forms, including peritoneal\nlesions,\novarian cysts (endometrioma), deep-seated variants, and extrapelvic involvement. The\nretrograde\nmenstruation hypothesis suggested backward movement of endometrial tissue through\nfallopian\ntubes, settling in the pelvis, causing inflammation and adhesions. Current research\nexplores\ngenetic and epigenetic origins, focusing on intracellular aromatase activity. This updated\nperspective investigates genetics, gene expression, and cellular activity, particularly\naromatase.\nIts manifestation includes not only pain, but disrupts also everyday life, having negative\nimpact to\ninfertility. Despite affecting 610% of women in their reproductive years, 50% of those\nseeking\nfertility treatment hide endometriosis lesions. \nStatistics suggest that approximately 1744% of women diagnosed with endometriosis\nwill\nexperience an endometrioma, the most prevalent form of endometriosis manifestation.\nThese lesions, colloquially known as \"chocolate cysts,\" owe their name to the dark\nbrown fluid they\ncontain. Beyond their appearance, endometriomas signal a more severe state of the\ndisease in\nindividuals with endometriosis. Research on endometrioma's effect on ovarian reserve,\nspecifically concerning serum anti-Müllerian hormone AMH) levels, has conflicting\nfindings. Some\nstudies indicate a decrease in AMH levels among women with endometriomas, while\nothers find no\nsignificant differences compared to control groups. To reach a conclusive\nunderstanding, more\nextensive and prolonged investigations are essential.\nSurgical interventions, notably excision of the cyst's capsule (cystectomy), show a\npotential to\nimprove post-operative pregnancy rates compared to drainage and ablative methods.\nYet, the\ndelicate ovarian tissue and follicles face possible harm from surgical excision. Fears of\novarian\nprotocols.io | https://dx.doi.org/10.17504/protocols.io.kqdg3227pv25/v1 October 16, 2024 5/11\n\nfailure after cystectomy have led healthcare providers to embrace ablative approaches.\nIn this\napproach, rather than entirely removing it, the \"pseudo-capsule\" undergoes ablation\nusing energy\nsources with limited thermal dispersion. A new approach, the 'one step' or 'three step'\nlaser\nvaporization, employing CO2 laser technology, Looks as a promising option by\nminimizing energy\nusage and consequently decreasing potential damage. It offers hope in preserving\nfertility while\neffectively managing endometrioma. Another alternative is sclerotherapy, aiming to\neliminate the pseudocapsule of an endometrioma by introducing alcoholic substances\ninto it. This\nmethod is regarded as a cost-effective and safe way to protect healthy ovarian tissue.\nThe\nprocedure involves injecting a sclerosing substance directly into the cyst, followed by\nrinsing or\nretaining it. Hydrosoluble dehydrating antiseptic fluids can alter the proteins in\nmicroorganism\nenvelopes and dissolve the lipids of their capsules. Ethanol is often chosen for its\nsuperior track\nrecord in managing renal and hepatic cysts. \nMaterial and methods\n2 The conduct of this systematic review will adhere to the guidelines set by the Preferred\nReporting Items for Reviews and Meta-Analyses PRISMA Statement. \nData sources and Search Strategy\nSearch will be conducted across two databases—PubMed and Europe PMC—to collect\narticles\ncontaining the keywords ‘surgical intervention for endometrioma, ovarian reserve,\npregnancy rates, fertilityʼ published between January 1, 2000, and October 30, 2023.\nEligibility Criteria for Articles of Inclusion \nThe articles will be limited to those written in English and only full research articles will\nbe included. Abstracts presented in scientific meetings will be excluded as well as review\narticles. Only articles presenting information about surgical intervention for\nendometrioma and their correlation with infertility parameters will be included. Any\narticles describing conservative treatment for endometrioma will be also excluded. To\nprotocols.io | https://dx.doi.org/10.17504/protocols.io.kqdg3227pv25/v1 October 16, 2024 6/11\n\navoid bias, articles that refer to the combined treatment of endometrioma will be also\nconsidered. \nData Extraction\nSpecific data will be extracted from each publication in duplicate, including publication\ndate, authorship, studied population, methodologies employed, criteria for inclusion or\nexclusion I/E, sample type, and primary outcome measures.\nResults\n3 Results will be presented in a standardized fashion and the publication and author data,\ndemographics, metrics, and key findings of the included studies will be tabulated to\noptimize readability.\nDiscussion\n4 A critical appraisal of the included studies will be undertaken.\nConclusion\n5 In this section, we will recapitulate the key findings of our research.\nprotocols.io | https://dx.doi.org/10.17504/protocols.io.kqdg3227pv25/v1 October 16, 2024 7/11\n\nProtocol references\n1. 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Surgical resection or aspiration with ethanol\nsclerotherapy of endometrioma before in vitro fertilization in infertilie women with endometrioma. Obstet\nGynecol Sci. 2014 Jul;574297303. \nprotocols.io | https://dx.doi.org/10.17504/protocols.io.kqdg3227pv25/v1 October 16, 2024 10/11\n\n49.Alborzi S, Askary E, Keramati P, Moradi Alamdarloo S, Poordast T, Ashraf MA, et al. Assisted reproductive\ntechnique outcomes in patients with endometrioma undergoing sclerotherapy vs laparoscopic cystectomy:\nProspective cross-sectional study. Reprod Med Biol. 2021 Jul;20331320. \n50.Yamamoto S, Umeki M, Maeda T, Yamaguchi M, Hamano T. Poor pregnancy outcome following assisted\nreproductive technology among women operated on for bilateral endometriomas. Reprod Med Biol. 2010\nMar;91439. \nprotocols.io | https://dx.doi.org/10.17504/protocols.io.kqdg3227pv25/v1 October 16, 2024 11/11","source_license":"CC0","license_restricted":false}