Endometriose und Kinderwunsch

In: Der Gynäkologe · 2020 · vol. 53(10) , pp. 666–670 · doi:10.1007/s00129-020-04667-3 · W3084555549
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Therapeutic approaches for endometriosis in women desiring conception differ from pain management, prioritizing assisted reproduction and fertility preservation over endocrine therapy due to surgical risks.

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This narrative review discusses therapeutic decision-making for women with endometriosis who have infertility or wish to conceive, contrasting approaches used for pain-focused patients with those used when reproductive goals predominate. It argues that endocrine therapy is not a suitable option in cases of infertility, and that surgical removal of endometriosis requires careful indication because surgery itself may threaten follicular reserve and fertility. Consistent with guidelines, the review states that assisted reproductive techniques should be prioritized in appropriate situations, and it highlights fertility preservation measures as potential options depending on the individual case, while noting the need for coordinated care between gynecologic surgeons and reproductive specialists. This paper is centrally about endometriosis — it focuses specifically on endometriosis management strategies in the context of child wish and infertility.

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Zusammenfassung Bei einer Patientin mit Endometriose und Kinderwunsch unterscheidet sich das therapeutische Vorgehen von dem bei einer Schmerzpatientin. So ist die endokrine Therapie bei Kinderwunsch keine sinnvolle Option. Eine operative Sanierung muss sorgfältig indiziert werden, da nicht nur die Endometriose, sondern auch der Eingriff selbst ein Risiko für die Fertilität darstellen kann. Nach Leitlinien werden besonders bei Endometriomen und Rezidiveingriffen reproduktionsmedizinische Verfahren als primäre therapeutische Option empfohlen. Neue Perspektiven für Endometriosepatientinnen bieten Maßnahmen der Fertilitätsprotektion, die im individuellen Fall sinnvoll sein können. Diese Übersicht fasst aktuelle Kenntnisse und Empfehlungen im Spannungsfeld Endometriose und Kinderwunsch zusammen. Sie ermutigt zu einer engen Zusammenarbeit zwischen Operateur und Reproduktionsmediziner. Abstract In women with endometriosis wishing to conceive, therapeutic strategies can differ significantly from those applied in patients suffering from endometriosis-associated pain. In the case of infertility, endocrine therapy is not an option. The resection of endometriosis needs to be carefully indicated since follicular reserve can be at risk due to the surgical procedure itself. According to recent guidelines, assisted reproductive techniques should be preferred in these cases. New perspectives are offered by measures of fertility preservation that can be beneficial in individual cases of endometriosis. This review summarizes recent knowledge and recommendations available in the field of endometriosis and infertility, encouraging close cooperation between gynecologic surgery and reproductive medicine. 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Acta Obstet Gynecol Scand 88:1074–1082. https://doi.org/10.1080/00016340903214973 Author information Authors and Affiliations Corresponding author Ethics declarations Interessenkonflikt A. Schüring und L. Kiesel geben an, dass kein Interessenkonflikt besteht. Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien. Additional information Redaktion L. Kiesel, Münster W. Janni, Ulm Rights and permissions About this article Cite this article Schüring, A., Kiesel, L. Endometriose und Kinderwunsch. Gynäkologe 53, 666–670 (2020). https://doi.org/10.1007/s00129-020-04667-3 Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s00129-020-04667-3

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