Endometrioma and Ovarian Reserve: A Surgical Approach

Ovarian endometriomas (OEs) are a frequent clinical manifestation of endometriosis. It is controversial how OE may affect women’s fertility, and it is an important consideration when planning treatment in women who want to retain the potential of future childbearing. This chapter will describe the association between OEs and diminished ovarian reserve, with a particular focus on spontaneous ovulation rates, markers of ovarian reserve, and response to ovarian stimulation. Based on current evidence, although there are plausible biological effects on the ovarian cortex surrounding OE and an impairment of the normal ovarian physiology, the impact of OE per se is not significant. There is a negligible detrimental effect on ovarian reserve with spontaneous ovulation not being impaired. Surgical removal of OE may worsen ovarian function by removing healthy ovarian cortex or compromising blood flow to the ovary. It is evident that surgical excision of OE acutely impairs ovarian function as measured by ovarian reserve markers. Additionally, a reduced response of the ovaries to gonadotrophins has been described after surgical removal of OE. Whether the decrease of ovarian function represents progressive or long-term impairment remains the subject of ongoing investigation. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

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Endometrioma and Ovarian Reserve: A Surgical Approach. In: Gomes-da-Silveira, G.G., da Silveira, G.P.G., Pessini, S.A. (eds) Minimally Invasive Gynecology. Springer, Cham. https://doi.org/10.1007/978-3-319-72592-5_10 Download citation DOI: https://doi.org/10.1007/978-3-319-72592-5_10 Published: Publisher Name: Springer, Cham Print ISBN: 978-3-319-72591-8 Online ISBN: 978-3-319-72592-5 eBook Packages: MedicineMedicine (R0)