Endometrioma e infertilidad: revisión de alternativas terapéuticas Endometriomas and infertility: a review of therapeutic alternatives

Gustavo Adolfo Restrepo-Cano
In: Revista Colombiana de Obstetricia y Ginecología, Vol 62, Iss 1, Pp 82-87 (2011) · 2011 · W2514262519
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Laparoscopic cystectomy for endometriomas was the most effective treatment, preserving ovarian reserve and reducing recurrence without negatively impacting IVF outcomes.

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This paper is a qualitative systematic review of the literature (searching PubMed/MEDLINE, Hinari, and Cochrane; February 2000 to March 2010) on treatments for endometriomas in the context of infertility, including English- and Spanish-language studies. Across included evidence, the authors report that differences among surgical techniques provide the best support for endometrioma management outcomes. Laparoscopic cystectomy is described as the most effective surgical approach, with the least impact on ovarian follicular reserve and a significantly reduced risk of recurrence, and it did not affect IVF pregnancy outcomes. This paper is centrally about endometriosis — it reviews therapeutic alternatives for endometriomas affecting infertility, emphasizing laparoscopic cystectomy.

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Abstract

Objetivo: realizar una revisión de la literatura sobre el tratamiento de los endometriomas en el área de la infertilidad. Materiales y métodos: el presente trabajo es una revisión sistemática cualitativa, para la cual se realizó una búsqueda electrónica en PubMed/ MEDLINE, Hinari y Cochrane, para recopilar información publicada tanto en inglés como en español desde febrero del 2000 a marzo del 2010, eligiendo aquellos artículos que evaluaban el tratamiento de los endometriomas en función de la infertilidad. Resultados: la mejor evidencia respecto al manejo de los endometriomas en infertilidad se encuentra en las diferencias de las técnicas quirúrgicas para su tratamiento. La cistectomía laparoscópica es el método quirúrgico más efectivo, afecta de menor manera la reserva ovárica folicular y disminuye de forma significativa el riesgo de recurrencias. No afecta los resultados de la FIV (fertilización in vitro) en términos de embarazos. Conclusiones: la cirugía excisional laparoscópica (cistectomía) de los endometriomas ofrece ventajas frente a las demás.Objective: reviewing the pertinent literature concerning endometrioma treatment in the area of infertility. Materials and methods: this work consisted of a qualitative systematic review involving a search of the PubMed/MEDLINE, Hinari and Cochrane databases to compile information published in both English and Spanish from February 2000 to March 2010, choosing those articles which evaluated treatment of endometriomas regarding infertility. Results: the best available evidence regarding the management of endometriomas in infertility was found in the differences between surgical techniques for treating them. Laparoscopic cystectomy was seen to be the most effective surgical method; it had the least effect on ovarian follicular reserve and significantly reduced the risk of recurrences. It did not affect in vitro fertilization (IVF) results in terms of pregnancies. Conclusions: laparoscopic excision surgery (cystectomy) of the endometriomas offers advantages when compared to other available techniques.
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Revista Colombiana de Obstetricia y Ginecología (Mar 2011) Endometrioma e infertilidad: revisión de alternativas terapéuticas Endometriomas and infertility: a review of therapeutic alternatives Abstract Objetivo: realizar una revisión de la literatura sobre el tratamiento de los endometriomas en el área de la infertilidad. Materiales y métodos: el presente trabajo es una revisión sistemática cualitativa, para la cual se realizó una búsqueda electrónica en PubMed/ MEDLINE, Hinari y Cochrane, para recopilar información publicada tanto en inglés como en español desde febrero del 2000 a marzo del 2010, eligiendo aquellos artículos que evaluaban el tratamiento de los endometriomas en función de la infertilidad. Resultados: la mejor evidencia respecto al manejo de los endometriomas en infertilidad se encuentra en las diferencias de las técnicas quirúrgicas para su tratamiento. La cistectomía laparoscópica es el método quirúrgico más efectivo, afecta de menor manera la reserva ovárica folicular y disminuye de forma significativa el riesgo de recurrencias. No afecta los resultados de la FIV (fertilización in vitro) en términos de embarazos. Conclusiones: la cirugía excisional laparoscópica (cistectomía) de los endometriomas ofrece ventajas frente a las demás.Objective: reviewing the pertinent literature concerning endometrioma treatment in the area of infertility. Materials and methods: this work consisted of a qualitative systematic review involving a search of the PubMed/MEDLINE, Hinari and Cochrane databases to compile information published in both English and Spanish from February 2000 to March 2010, choosing those articles which evaluated treatment of endometriomas regarding infertility. Results: the best available evidence regarding the management of endometriomas in infertility was found in the differences between surgical techniques for treating them. Laparoscopic cystectomy was seen to be the most effective surgical method; it had the least effect on ovarian follicular reserve and significantly reduced the risk of recurrences. It did not affect in vitro fertilization (IVF) results in terms of pregnancies. Conclusions: laparoscopic excision surgery (cystectomy) of the endometriomas offers advantages when compared to other available techniques.

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endometriomainfertility

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