Endometrioma and assisted reproductive technology: a review

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AI-generated summary by claude@2026-06+body, 2026-06-10

This review assesses literature on endometrioma surgery's impact on ART outcomes, finding evidence that surgery may harm ovarian reserve but that pregnancy and birth rates remain similar.

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AI-generated deep summary by claude@2026-06, 2026-06-08 · read from full text

This paper is a narrative review assessing evidence on how endometrioma surgery performed before assisted reproductive technology (ART) affects fertility outcomes, focusing on studies comparing outcomes before versus after surgery in women with endometriomas. The authors report growing evidence that surgery might damage ovarian reserve—potentially reducing ART success—while pregnancy rates, implantation rates, fertilization rates, and live birth rates appear broadly similar between surgical and non-surgical groups. The review concludes that the overall evidence is inconclusive, explicitly calling for further large randomized controlled trials, and notes that management has been individualized in the interim. This paper is centrally about endometriosis — specifically, it reviews whether ovarian endometrioma surgery prior to ART impacts fertility outcomes and ovarian reserve.

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Abstract

Purpose Endometriomas are a common cause of infertility necessitating assisted reproductive technology (ART). It had been previously thought that surgical removal of the endometriomas prior to ART would improve reproductive outcomes, but recent data suggests that surgical cystectomy might affect the ovarian reserve, decreasing the chances of ART success. The aim of this article is to review the literature on the effects of endometrioma surgery on ART outcomes providing an overview of the current evidence and assessing the need for further studies.

Methods

A literature search was performed using PubMed and MEDLINE databases to identify studies that discuss endometriomas and assisted reproductive technology before versus after surgery.

Results

In women with an endometrioma requiring ART, growing evidence suggests that surgery might result in damage to the ovarian reserve and further decrease chances of fertility. However, pregnancy rates, implantation rates, fertilization rates, and live birth rates seemed to be consistently similar across both groups.

Conclusion

The current evidence is inconclusive on whether endometriomas should be surgically removed prior to ART. Further large randomized controlled trials are needed for a definite answer, and until then, management should be individualized. Similar content being viewed by others

References

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Rights and permissions About this article Cite this article Kheil, M.H., Sharara, F.I., Ayoubi, J.M. et al. Endometrioma and assisted reproductive technology: a review. J Assist Reprod Genet 39, 283–290 (2022). https://doi.org/10.1007/s10815-022-02403-5 Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s10815-022-02403-5

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Condition tags

endometriosisendometrioma

MeSH descriptors

Endometriosis Endometriosis Endometriosis Infertility, Female Infertility, Female Ovarian Reserve Birth Rate Female Humans Pregnancy Pregnancy Rate Reproductive Techniques, Assisted Reproductive Techniques, Assisted

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