Paraportal localisation of an endometriotic ovarian cyst and its influence on ovarian reserve and intensity of chronic pelvic pains

This study evaluated how paraportal versus peripheral localization of a unilateral endometriotic ovarian cyst (2–8 cm) affects ovarian reserve and the intensity of chronic pelvic pain in 100 patients with chronic pelvic pain associated with external genital endometriosis, using ultrasound and hormonal measures (antral follicle count, power Doppler vascularization and flow indices, AMH, and FSH) and the Biberoglu and Behrman scale for pain. Compared with 30 controls without ovarian cysts and with preserved reproductive function, patients with endometriotic ovarian cysts had a 22–50% decrease in ovarian reserve across AMH, FSH, antral follicles, and Doppler indices. The ovarian reserve was significantly more reduced and chronic pelvic pain more intense in the paraportal localization group than in the peripheral localization group, with laparoscopic findings confirming localization and capsular attachment firmness intraoperatively. This paper is centrally about endometriosis — it focuses on how localization of an endometriotic ovarian cyst relates to ovarian reserve and chronic pelvic pain intensity.

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