Endometrioma-Associated Infertility: Is Surgery Still the Best Way to Go?

Ludovico Muzii, Francesca Lecce, Chiara Achilli, Morena Antonilli, Angela Musella, Innocenza Palaia, Pierluigi Benedetti Panici
In: Journal of Endometriosis and Pelvic Pain Disorders · 2013 · vol. 5(4) , pp. 127–133 · doi:10.5301/je.5000164 · W2018058933
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⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

This review of literature comparing surgery and IVF for endometrioma-associated infertility concludes that laparoscopic endometrioma excision remains the treatment of choice, particularly for associated pain, when performed with techniques that minimize ovarian reserve damage.

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Abstract

Purpose Endometriomas are frequently associated with female infertility. In these cases, management options include surgery and IVF. The purpose of the present review is to evaluate current literature on the treatment of endometrioma-associated infertility and to compare the pros and cons of the different therapeutic approaches. Methods Literature search of published studies on the treatment of ovarian endometriomas in infertile patients. Studies were evaluated both on the efficacy of the surgical treatment on postoperative reproductive outcome and on the effect of surgery on the ovarian reserve. Results Pregnancy rates around 50% have been consistently reported after surgery, which compare favorably with those obtained with IVF. Surgery is effective also on associated pain, and the histological evaluation of the excised specimen rules out a possible unexpected ovarian malignancy. Thorough histological analysis of the excised specimen permits the evaluation of the appropriateness of surgery. Conclusions Laparoscopic excision of the ovarian endometrioma in infertile patients should still be considered the treatment of choice, particularly in case of associated pain. Surgery should be performed following appropriate techniques, and by dedicated surgeons, in order to decrease the possible damage to the ovarian reserve that has been recently reported postoperatively.

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endometriomainfertility

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