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This review examines the pathogenic mechanisms by which ovarian endometriomas impair ovarian function, specifically focusing on oxidative stress, inflammation, and fibrosis that disrupt folliculogenesis and reduce ovarian reserve. The authors detail how elevated reactive oxygen species accelerate follicular atresia while noting that surgical excision of these cysts further compromises ovarian reserve despite not significantly affecting live birth rates in IVF treatments. A major caveat highlighted is that while endometriosis pathogenesis remains unclear with multiple proposed mechanisms, the direct impact of endometriomas on oocyte quality versus quantity requires further elucidation to optimize clinical management strategies for infertility. This paper is centrally about endometriosis — specifically addressing the pathological effects and treatment implications of ovarian endometriomas, a common manifestation of the disease.
Abstract
Ovarian endometriomas (OEMs), cystic formations within the ovaries, are a significant manifestation of endometriosis and present in 20–40% of affected women. Despite extensive research, the pathogenesis of endometriosis remains unclear, with retrograde menstruation, coelomic metaplasia, and lymphatic dissemination being proposed mechanisms. OEMs negatively impact ovarian function by reducing the ovarian reserve, disrupting folliculogenesis, and altering the ovarian microenvironment through oxidative stress, inflammation, and fibrosis. Elevated reactive oxygen species (ROS) accelerate follicular atresia, and extracellular matrix remodeling contributes to ovarian damage, while immune dysregulation and cytokine imbalances further exacerbate the condition. The presence of OEMs does not significantly affect live birth rates in in vitro fertilization (IVF) treatments, despite potential reductions in the quality and quantity of oocytes. However, their surgical excision compromises the ovarian reserve. This review highlights the complex mechanisms by which OEMs impair ovarian function and emphasizes the need for further research to develop strategies that mitigate these effects, ultimately improving reproductive outcomes for women with endometriomas.
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Please use this identifier to cite or link to this item:
doi:10.22028/D291-45048
| Title: | Mechanisms of Endometrioma-Mediated Ovarian Damage: Myths and Facts |
| Author(s): | Özcan, Pınar Varlı, Bulut Sarıdoğan, Ertan Oral, Engin Mabrouk, Muhammed Usta, Taner Constantin, Alin Stefan |
| Language: | English |
| Title: | Journal of Clinical Medicine |
| Volume: | 14 |
| Issue: | 7 |
| Publisher/Platform: | MDPI |
| Year of Publication: | 2025 |
| Free key words: | endometrioma ovarian reserve in vitro fertilization infertility endometriosis |
| DDC notations: | 610 Medicine and health |
| Publikation type: | Journal Article |
| Abstract: | Ovarian endometriomas (OEMs), cystic formations within the ovaries, are a significant manifestation of endometriosis and present in 20–40% of affected women. Despite extensive research, the pathogenesis of endometriosis remains unclear, with retrograde menstruation, coelomic metaplasia, and lymphatic dissemination being proposed mechanisms. OEMs negatively impact ovarian function by reducing the ovarian reserve, disrupting folliculogenesis, and altering the ovarian microenvironment through oxidative stress, inflammation, and fibrosis. Elevated reactive oxygen species (ROS) accelerate follicular atresia, and extracellular matrix remodeling contributes to ovarian damage, while immune dysregulation and cytokine imbalances further exacerbate the condition. The presence of OEMs does not significantly affect live birth rates in in vitro fertilization (IVF) treatments, despite potential reductions in the quality and quantity of oocytes. However, their surgical excision compromises the ovarian reserve. This review highlights the complex mechanisms by which OEMs impair ovarian function and emphasizes the need for further research to develop strategies that mitigate these effects, ultimately improving reproductive outcomes for women with endometriomas. |
| DOI of the first publication: | 10.3390/jcm14072147 |
| URL of the first publication: | https://doi.org/10.3390/jcm14072147 |
| Link to this record: | urn:nbn:de:bsz:291--ds-450485 hdl:20.500.11880/39916 http://dx.doi.org/10.22028/D291-45048 |
| ISSN: | 2077-0383 |
| Date of registration: | 14-Apr-2025 |
| Faculty: | M - Medizinische Fakultät |
| Department: | M - Frauenheilkunde |
| Professorship: | M - Prof. Dr. E.-F. Solomayer |
| Collections: | SciDok - Der Wissenschaftsserver der Universität des Saarlandes |
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| jcm-14-02147.pdf | 825,64 kB | Adobe PDF | View/Open |
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