ATTITUDES AND PRACTICES OF OBSTETRICIAN GYNAECOLOGISTS IN IRELAND TOWARDS OPTIMISING FERTILITY IN YOUNG WOMEN WITH MODERATE/SEVERE ENDOMETRIOSIS: A SCOPING SURVEY

Maebh Horan, Glover L, Louise Glover, Mary Wingfield, Wingfield M
In: Authorea Inc. · 2025 · doi:10.22541/au.174255510.05676035/v1 · W4408688836
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-07-09 ⓘ

Obstetricians/gynecologists in Ireland frequently consider age and fertility desire but show heterogeneity in assessing ovarian reserve and discussing fertility preservation for young women with moderate/severe endometriosis.

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⚙ AI-generated deep summary by claude@2026-07, 2026-07-17 · read from full text ⓘ

This scoping questionnaire study investigated how obstetricians and gynaecologists in Ireland approach fertility optimization for young women with moderate to severe endometriosis who had not completed childbearing, using an anonymous online survey of consultants and trainees identified through Irish professional and training bodies. Most respondents reported considering age and fertility desire (98%), using ultrasound before operating (71%), and some discussing ovarian reserve impacts (e.g., 37% discussing ovarian cystectomy risk; 36% usually performing AMH testing), while 86% reported counselling patients to consider starting a family. However, only 25% routinely discussed fertility preservation before complex surgery, and the authors attribute the low consideration of ovarian reserve assessment and ART options (including IVF and egg freezing) potentially to lack of public funding at the time of the survey. This paper is centrally about endometriosis — it surveys Irish clinicians’ attitudes and practices regarding fertility optimization and fertility preservation for moderate/severe endometriosis.

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Abstract

Objective To investigate the approach of obstetricians and gynaecologists in Ireland to optimising the fertility of young women with moderate to severe endometriosis, who have not yet completed their family. Design Scoping questionnaire Setting The study survey was delivered via an anonymous online survey platform forum. Population Doctors working in Obstetrics and Gynaecology in Ireland Methods A scoping survey was delivered via an online forum. Obstetrics and gynaecology consultants and trainees were identified through the national professional and training body for Obstetrics and Gynaecology in Ireland. Results Almost 60% of respondents were consultants or senior registrars. Most (98%) take age and fertility desire into consideration when planning treatment, 71% always perform ultrasound prior to operating, with 36% usually performing an AMH test, and 37% discussing the risk of ovarian cystectomy to patient ovarian reserve. Although most (86%) reported counselling women with moderate to severe endometriosis to consider starting a family, only 25% routinely discuss fertility preservation before complex surgery. Conclusion This study demonstrates the significant heterogeneity in the management of women with severe endometriosis in Ireland. There is a low level of assessment of ovarian reserve and consideration of ART procedures such as IVF and egg freezing. This may have been related to the lack of public funding for these services in Ireland at the time of this survey. Further studies are needed to try define the characteristics of women with endometriosis who will benefit most from fertility preservation.
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Abstract

Objective To investigate the approach of obstetricians and gynaecologists in Ireland to optimising the fertility of young women with moderate to severe endometriosis, who have not yet completed their family. Design Scoping questionnaire Setting The study survey was delivered via an anonymous online survey platform forum. Population Doctors working in Obstetrics and Gynaecology in Ireland Methods A scoping survey was delivered via an online forum. Obstetrics and gynaecology consultants and trainees were identified through the national professional and training body for Obstetrics and Gynaecology in Ireland.

Results

Almost 60% of respondents were consultants or senior registrars. Most (98%) take age and fertility desire into consideration when planning treatment, 71% always perform ultrasound prior to operating, with 36% usually performing an AMH test, and 37% discussing the risk of ovarian cystectomy to patient ovarian reserve. Although most (86%) reported counselling women with moderate to severe endometriosis to consider starting a family, only 25% routinely discuss fertility preservation before complex surgery. Conclusion This study demonstrates the significant heterogeneity in the management of women with severe endometriosis in Ireland. There is a low level of assessment of ovarian reserve and consideration of ART procedures such as IVF and egg freezing. This may have been related to the lack of public funding for these services in Ireland at the time of this survey. Further studies are needed to try define the characteristics of women with endometriosis who will benefit most from fertility preservation. Hosted file MH BJOG 200325.docx available at https://authorea.com/users/733588/articles/1279347- attitudes-and-practices-of-obstetrician-gynaecologists-in-ireland-towards-optimising- fertility-in-young-women-with-moderate-severe-endometriosis-a-scoping-survey Hosted file MH BJOG Figures.docx available at https://authorea.com/users/733588/articles/1279347- attitudes-and-practices-of-obstetrician-gynaecologists-in-ireland-towards-optimising- fertility-in-young-women-with-moderate-severe-endometriosis-a-scoping-survey Hosted file MH BJOG Tables .docx available at https://authorea.com/users/733588/articles/1279347- attitudes-and-practices-of-obstetrician-gynaecologists-in-ireland-towards-optimising- fertility-in-young-women-with-moderate-severe-endometriosis-a-scoping-survey 1

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