Endometrioma and Infertility: Principles and Techniques of Management

Endometriosis occurs when endometrial tissue is detected outside of the uterus. The prevalence of endometriosis depends on the diagnostic method, but ranges between 25 and 40 % of women. The relationship of endometriosis to infertility is not always clear-cut. A review of 32 studies by Eskenazi showed that up to 78 % of infertile women had endometriosis. Similarly, D’Hooghe et al. pooled 13 studies, demonstrating that up to 50 % of previously fertile women had proven endometriosis. An endometrioma is formed following the invagination of endometriotic deposits on the ovarian cortex, eventually forming what is commonly described as ‘chocolate’ cysts. Ovarian endometriomas are found in 17–44 % of women with endometriosis. Although the ovaries are the commonest sites of endometriomas, there are numerous reports of extra-gonadal chocolate cysts in distant locations like the umbilicus, brain, liver and other sites. These extra-gonadal lesions do not, however, have direct effects on infertility. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

Buck Louis GM, Hediger ML, Peterson CM, Croughan M, Sundaram R, Stanford J, et al. Incidence of endometriosis by study population and diagnostic method: the ENDO study. Fertil Steril. 2011;96(2):360–5. Eskenazi B, Warner ML. Epidemiology of endometriosis. Obstet Gynecol Clin North Am. 1997;24(2):235–58. D'Hooghe TM, Debrock S, Hill JA, Meuleman C. Endometriosis and subfertility: is the relationship resolved? Semin Reprod Med. 2003;21(2):243–54. Nisolle M, Donnez J. Peritoneal endometriosis, ovarian endometriosis, and adenomyotic nodules of the rectovaginal septum are three different entities. Fertil Steril. 1997;68(4):585–96. Redwine DB. Ovarian endometriosis: a marker for more extensive pelvic and intestinal disease. Fertil Steril. 1999;72(2):310–5. Busacca M, Vignali M. Ovarian endometriosis: from pathogenesis to surgical treatment. Curr Opin Obstet Gynecol. 2003;15(4):321–6. Galasso A, Sherman BG, Burn VE. Umbilical endometrioma. JAMA. 1934;102(22):1845–6. Efremidou EI, Kouklakis G, Mitrakas A, Liratzopoulos N, Polychronidis AC. Primary umbilical endometrioma: a rare case of spontaneous abdominal wall endometriosis. Int J Gen Med. 2012;5:999–1002. Thibodeau LL, Prioleau GR, Manuelidis EE, Merino MJ, Heafner MD. Cerebral endometriosis. case report. J Neurosurg. 1987;66(4):609–10. Huang WT, Chen WJ, Chen CL, Cheng YF, Wang JH, Eng HL. Endometrial cyst of the liver: a case report and review of the literature. J Clin Pathol. 2002;55(9):715–7. Rivkine E, Jakubowicz D, Marciano L, Polliand C, Poncelet C, Ziol M, et al. Hepatic endometrioma: a case report and review of the literature: report of a case. Surg Today. 2013;43(10):1188–93. Padilla SL. Ovarian abscess following puncture of an endometrioma during ultrasound-guided oocyte retrieval. Hum Reprod. 1993;8(8):1282–3. Yaron Y, Peyser MR, Samuel D, Amit A, Lessing JB. Infected endometriotic cysts secondary to oocyte aspiration for in-vitro fertilization. Hum Reprod. 1994;9(9):1759–60. Nargund G, Parsons J. Infected endometriotic cysts secondary to oocyte aspiration for in-vitro fertilization. Hum Reprod. 1995;10(6):1555. Fujishita A, Khan KN, Masuzaki H, Ishimaru T. Influence of pelvic endometriosis and ovarian endometrioma on fertility. Gynecol Obstet Invest. 2002;53 Suppl 1:40–5. Dunselman GA, Vermeulen N, Becker C, Calhaz-Jorge C, D'Hooghe T, De Bie B, et al. ESHRE guideline: management of women with endometriosis. Hum Reprod. 2014;15. Hughes E, Brown J, Collins JJ, Farquhar C, Fedorkow DM, Vandekerckhove P. Ovulation suppression for endometriosis. Cochrane Database Syst Rev. 2007;(3):CD000155. Rana N, Thomas S, Rotman C, Dmowski WP. Decrease in the size of ovarian endometriomas during ovarian suppression in stage IV endometriosis. Role of preoperative medical treatment. J Reprod Med. 1996;41(6):384–92. Sallam HN, Garcia-Velasco JA, Dias S, Arici A. Long-term pituitary down-regulation before in vitro fertilization (IVF) for women with endometriosis. Cochrane Database Syst Rev. 2006;(1):CD004635. Nothnick WB. The emerging use of aromatase inhibitors for endometriosis treatment. Reprod Biol Endocrinol. 2011;9:87. doi:10.1186/1477-7827-9-87. Lossl K, Loft A, Freiesleben NL, Bangsboll S, Andersen CY, Pedersen AT, et al. Combined down-regulation by aromatase inhibitor and GnRH-agonist in IVF patients with endometriomas-A pilot study. Eur J Obstet Gynecol Reprod Biol. 2009;144(1):48–53. Fertility: assessment and treatment for people with fertility problems issued: NICE clinical guideline 156. [Internet]. 2013. Available from: http://www.nice.org.uk/nicemedia/live/14078/62769/62769.pdf. Chapron C, Vercellini P, Barakat H, Vieira M, Dubuisson JB. Management of ovarian endometriomas. Hum Reprod Update. 2002;8(6):591–7. Pados G, Tsolakidis D, Bontis J. Laparoscopic management of the adnexal mass. Ann N Y Acad Sci. 2006;1092:211–28. Tsolakidis D, Pados G, Vavilis D, Athanatos D, Tsalikis T, Giannakou A, et al. The impact on ovarian reserve after laparoscopic ovarian cystectomy versus three-stage management in patients with endometriomas: a prospective randomized study. Fertil Steril. 2010;94(1):71–7. Hart RJ, Hickey M, Maouris P, Buckett W. Excisional surgery versus ablative surgery for ovarian endometriomata. Cochrane Database Syst Rev. 2008;(2):CD004992. Benschop L, Farquhar C, van der Poel N, Heineman MJ. Interventions for women with endometrioma prior to assisted reproductive technology. Cochrane Database Syst Rev. 2010;(11):CD008571. Kenney SP, Kekuda R, Prasad PD, Leibach FH, Devoe LD, Ganapathy V. Cannabinoid receptors and their role in the regulation of the serotonin transporter in human placenta. Am J Obstet Gynecol. 1999;181(2):491–7. Kennedy S, Bergqvist A, Chapron C, D'Hooghe T, Dunselman G, Greb R, et al. ESHRE guideline for the diagnosis and treatment of endometriosis. Hum Reprod. 2005;20(10):2698–704. Takashima A, Takeshita N, Otaka K, Kinoshita T. Effects of bipolar electrocoagulation versus suture after laparoscopic excision of ovarian endometrioma on the ovarian reserve and outcome of in vitro fertilization. J Obstet Gynaecol Res. 2013;39(7):1246–52. Ferrero S, Venturini PL, Gillott DJ, Remorgida V, Leone Roberti Maggiore U. Hemostasis by bipolar coagulation versus suture after surgical stripping of bilateral ovarian endometriomas: a randomized controlled trial. J Minim Invasive Gynecol. 2012;19(6):722–30. Tsoumpou I, Kyrgiou M, Gelbaya TA, Nardo LG. The effect of surgical treatment for endometrioma on in vitro fertilization outcomes: a systematic review and meta-analysis. Fertil Steril. 2009;92(1):75–87. Benaglia L, Bermejo A, Somigliana E, Faulisi S, Ragni G, Fedele L, et al. In vitro fertilization outcome in women with unoperated bilateral endometriomas. Fertil Steril. 2013;99(6):1714–9. Rickes D, Nickel I, Kropf S, Kleinstein J. Increased pregnancy rates after ultralong postoperative therapy with gonadotropin-releasing hormone analogs in patients with endometriosis. Fertil Steril. 2002;78(4):757–62. Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations Rights and permissions Copyright information © 2015 Springer-Verlag London About this chapter Cite this chapter Karasu, T., Ola, B. (2015). Endometrioma and Infertility: Principles and Techniques of Management. In: Metwally, M., Li, TC. (eds) Reproductive Surgery in Assisted Conception. Springer, London. https://doi.org/10.1007/978-1-4471-4953-8_4 Download citation DOI: https://doi.org/10.1007/978-1-4471-4953-8_4 Publisher Name: Springer, London Print ISBN: 978-1-4471-4952-1 Online ISBN: 978-1-4471-4953-8 eBook Packages: MedicineMedicine (R0)