Endometriosis

In: Fertility Preservation in Oncological and Non-Oncological Diseases · 2020 · pp. 133–144 · doi:10.1007/978-3-030-47568-0_16 · W4241743266
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Advanced endometriosis risks reduced ovarian reserve, necessitating fertility preservation through medical treatment and conservative surgery, with oocyte freezing an option for significant fertility decline.

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This chapter reviews fertility preservation considerations in advanced endometriosis, focusing on how endometriosis and related surgery can reduce ovarian reserve and affect fertility, and outlining approaches such as ovarian stimulation with oocyte cryopreservation or ovarian-conserving surgery by specialized surgeons. It highlights that for anticipated substantial fertility loss—such as in young women with deep infiltrating disease or bilateral endometriomas, or in women with one remaining ovary—oocyte stimulation and freezing may be used, with stimulation regimens needing adaptation to avoid complications. A key practical caveat stated is that ovarian surgery should not be performed directly after follicle aspiration. This paper is centrally about endometriosis — it discusses fertility preservation strategies in advanced endometriosis and their relationship to ovarian reserve and timing of ovarian surgery.

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Abstract

In advanced endometriosis, there is a substantial risk of a reduction of the ovarian reserve. Both the endometriosis itself and the required surgery can affect ovarian function and fertility. For fertility preservation medical treatment to slow down the progression of the disease and ovary conserving surgery by specialised surgeons are essential. If a substantial decrease in fertility is expected as in young women with deep infiltrating endometriosis or in women with endometrioma of both ovaries or of one remaining ovary, ovarian stimulation and freezing of oocytes can be an option. The stimulation regime needs to be adapted to avoid complications and ovarian surgery should not be performed directly after follicle aspiration. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

References

Viganò P, Parazzini F, Somigliana E, Vercellini P. Endometriosis: epidemiology and aetiological factors. Best Pract Res Clin Obstet Gynaecol. 2004;18:177–200. de Ziegler D, Borghese B, Chapron C. Endometriosis and infertility: pathophysiology and management. Lancet. 2010;376:730–8. Brosens I, Gordts S, Benagiano G. Endometriosis in adolescents is a hidden, progressive and severe disease that deserves attention, not just compassion. Hum Reprod. 2013;28:2026–31. Benagiano G, Guo S-W, Puttemans P, Gordts S, Brosens I. Progress in the diagnosis and management of adolescent endometriosis: an opinion. Reprod Biomed Online. 2018;36:102–14. Vercellini P, Trespidi L, De Giorgi O, Cortesi I, Parazzini F, Crosignani PG. Endometriosis and pelvic pain: relation to disease stage and localization. Fertil Steril. 1996;65:299–304. Guzick DS, Silliman NP, Adamson GD, Buttram VC, Canis M, Malinak LR, Schenken R. Prediction of pregnancy in infertile women based on the American Society for Reproductive Medicine’s revised classification of endometriosis. Fertil Steril. 1997;67:822–9. American Society for Reproductive. Revised American Society for Reproductive Medicine classification of endometriosis: 1996. Fertil Steril. 1997;67:817–21. Haas D, Chvatal R, Habelsberger A, Wurm P, Schimetta W, Oppelt P. Comparison of revised American Fertility Society and ENZIAN staging: a critical evaluation of classifications of endometriosis on the basis of our patient population. Fertil Steril. 2011;95:1574–8. Lebovic DI, Mueller MD, Taylor RN. Immunobiology of endometriosis. Fertil Steril. 2001;75:1–10. Wu G, Bersinger NA, Mueller MD, von Wolff M. Intrafollicular inflammatory cytokines but not steroid hormone concentrations are increased in naturally matured follicles of women with proven endometriosis. J Assist Reprod Genet. 2017;34:357–64. Oral E, Seli E, Bahtiyar MO, Olive DL, Arici A. Growth-regulated alpha expression in the peritoneal environment with endometriosis. Obstet Gynecol. 1996;88:1050–6. Lyons RA, Djahanbakhch O, Saridogan E, Naftalin AA, Mahmood T, Weekes A, Chenoy R. Peritoneal fluid, endometriosis, and ciliary beat frequency in the human fallopian tube. Lancet. 2002;360:1221–2. Ota H, Igarashi S, Sato N, Tanaka H, Tanaka T. Involvement of catalase in the endometrium of patients with endometriosis and adenomyosis. Fertil Steril. 2002;78:804–9. Grandi G, Mueller MD, Bersinger NA, Facchinetti F, McKinnon BD. The association between progestins, nuclear receptors expression and inflammation in endometrial stromal cells from women with endometriosis. Gynecol Endocrinol. 2017;33:712–5. McKinnon BD, Kocbek V, Nirgianakis K, Bersinger NA, Mueller MD. Kinase signalling pathways in endometriosis: potential targets for non-hormonal therapeutics. Hum Reprod Update. 2016;22:382–403. Patel BG, Rudnicki M, Yu J, Shu Y, Taylor RN. Progesterone resistance in endometriosis: origins, consequences and interventions. Acta Obstet Gynecol Scand. 2017;96:623–32. McKinnon B, Mueller M, Montgomery G. Progesterone resistance in endometriosis: an acquired property? Trends Endocrinol Metab. 2018;29:535–48. Giudice LC. Endometriosis. N Engl J Med. 2010;362:2389–98. Santamaria X, Massasa EE, Taylor HS. Migration of cells from experimental endometriosis to the uterine endometrium. Endocrinology. 2012;153:5566–74. Vallvé-Juanico J, Houshdaran S, Giudice LC. The endometrial immune environment of women with endometriosis. Hum Reprod Update. 2019;25:565–92. Sanchez AM, Papaleo E, Corti L, Santambrogio P, Levi S, Vigano P, Candiani M, Panina-Bordignon P. Iron availability is increased in individual human ovarian follicles in close proximity to an endometrioma compared with distal ones. Hum Reprod. 2014;29:577–83. Kitajima M, Defrère S, Dolmans M-M, Colette S, Squifflet J, Van Langendonckt A, Donnez J. Endometriomas as a possible cause of reduced ovarian reserve in women with endometriosis. Fertil Steril. 2011;96:685–91. Kohl Schwartz AS, Wölfler MM, Mitter V, Rauchfuss M, Haeberlin F, Eberhard M, von Orelli S, Imthurn B, Imesch P, Fink D, Leeners B. Endometriosis, especially mild disease: a risk factor for miscarriages. Fertil Steril. 2017;108:806–14. Somigliana E, Marchese MA, Frattaruolo MP, Berlanda N, Fedele L, Vercellini P. Serum anti-mullerian hormone in reproductive aged women with benign ovarian cysts. Eur J Obstet Gynecol Reprod Biol. 2014;180:142–7. Bourdon M, Raad J, Dahan Y, Marcellin L, Maignien C, Even M, Pocate-Cheriet K, Lamau M, Santulli P, Chapron C. Endometriosis and ART: A prior history of surgery for OMA is associated with a poor ovarian response to hyperstimulation. PLoS One. 2018;13:e0202399. Benaglia L, Bermejo A, Somigliana E, Faulisi S, Ragni G, Fedele L, Garcia-Velasco J. In vitro fertilization outcome in women with unoperated bioateral endometriomas. Fertil Steril. 2013;99:1714–9. Benaglia L, Somigliana E, Vercellini P, Abbiati A, Ragni G, Fedele L. Endometriotic ovarian cysts negatively affect the rate of spontaneous ovulation. Hum Reprod. 2009;24:2183–6. Raffi F, Metwally M, Amer S. The impact of excision of ovarian endometrioma on ovarian reserve: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2012;97:3146–54. Hirokawa W, Iwase A, Goto M, Takikawa S, Nagatomo Y, Nakahara T, Bayasula B, Nakamura T, Manabe S, Kikkawa F. The post-operative decline in serum anti-Müllerian hormone correlates with the bilaterality and severity of endometriosis. Hum Reprod. 2011;26:904–10. Hamdan M, Dunselman G, Li TC, Cheong Y. The impact of endometrioma on IVF/ICSI outcomes: a systematic review and meta-analysis. Hum Reprod Update. 2015;21:809–25. Adamson GD, Pasta DJ. Endometriosis fertility index: the new, validated endometriosis staging system. Fertil Steril. 2010;94:1609–15. Tomassetti C, Geysenbergh B, Meuleman C, Timmerman D, Fieuws S, D’Hooghe T. External validation of the endometriosis fertility index (EFI) staging system for predicting non-ART pregnancy after endometriosis surgery. Hum Reprod. 2013;28:1280–8. Dunselman GA, Vermeulen N, Becker C, Calhaz-Jorge C, D’Hooghe T, De Bie B, Heikinheimo O, Horne AW, Kiesel L, Nap A, Prentice A, Saridogan E, Soriano D, Nelen W, European Society of Human Reproduction and Embryology. ESHRE guideline: management of women with endometriosis. Hum Reprod. 2014;29:400–12. Muzii L, Di Tucci C, Di Feliciantonio M, Marchetti C, Perniola G, Panici PB. The effect of surgery for endometrioma on ovarian reserve evaluated by antral follicle count: a systematic review and meta-analysis. Hum Reprod. 2014;29:2190–8. Ferrero S, Venturini PL, Gillott DJ, Remorgida V, Leone Roberti Maggiore U. Hemostasis by bipolar coagulation versus suture after surgical stripping of bilateral ovarian endometriomas: a randomized controlled trial. J Minim Invasive Gynecol. 2012;19:722–30. Muzii L, Achilli C, Bergamini V, Candiani M, Garavaglia E, Lazzeri L, Lecce F, Maiorana A, Maneschi F, Marana R, Perandini A, Porpora M, Seracchioli R, Spangolo E, Vignali M, Benedetti PP. Comparison between the stripping technique and the combined excisional/ablative technique for the treatment of bilateral ovarian endometriomas: a multicentre RCT. Hum Reprod. 2016;31:339–44. Elizur SE, Chian R-C, Holzer HEG, Gidoni Y, Tulandi T, Tan SL. Cryopreservation of oocytes in a young woman with severe and symptomatic endometriosis: a new indication for fertility preservation. Fertil Steril. 2009;91:293.e1–3. Raad J, Sonigo C, Tran C, Sifer C, Cedrin Durnerin I, Grynberg M. Oocyte vitrification for preserving fertility in patients with endometriosis: first observational cohort study and many unresolved questions. Eur J Obstet Gynecol Reprod Biol. 2018;220:140–1. Cobo A, García-Velasco JA. Why all women should freeze their eggs. Curr Opin Obstet Gynecol. 2016;28:206–10. Seyhan A, Urman B, Turkgeldi E, Ata B. Do endometriomas grow during ovarian stimulation for assisted reproduction? A three-dimensional volume analysis before and after ovarian stimulation. Reprod Biomed Online. 2018;36:239–44. Kim SJ, Choo CW, Kim SK, Lee JR, Jee BC, Suh CS, Lee W, Kim S. The effects of letrozole on women with endometriosis undergoing ovarian stimulation for in vitro fertilization. Gynecol Endocrinol. 2019;36:257–60. Chen M-J, Yang J-H, Yang Y-S, Ho H-N. Increased occurrence of tubo-ovarian abscesses in women with stage III and IV endometriosis. Fertil Steril. 2004;82:498–9. Yaron Y, Peyser MR, Samuel D, Amit A, Lessing JB. Infected endometriotic cysts secondary to oocyte aspiration for in-vitro fertilization. Hum Reprod. 1994;9:1759–60. Benaglia L, Somigliana E, Iemmello R, Colpi E, Nicolosi AE, Ragni G. Endometrioma and oocyte retrieval–induced pelvic abscess: a clinical concern or an exceptional complication? Fertil Steril. 2008;89:1263–6. von Wolff M, Stute P. Hormonelle Substanzklassen. Gynäkologische Endokrinologie und Reproduktionsmedizin. Schattauer 1. Ausgabe, 2013:5-18. Xue Cao, Hong-yang Chang, Jun-yan Xu, Yi Zheng, Yun-gai Xiang, Bing Xiao, Xu-jing Geng, Li-li Ni, Xi-ying Chu, Shi-bo Tao, Yan He, Gen-hong Mao. The effectiveness of different down-regulating protocols on in vitro fertilization-embryo transfer in endometriosis: a meta-analysis. Reprod Biol and Endocrinol. 2020;18:1. Niu Z, Chen Q, Sun Y, Feng Y. Long-term pituitary downregulation before frozen embryo transfer could improve pregnancy outcomes in women with adenomyosis. Gynecol Endocrinol. 2013;29:1026–30. Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations Rights and permissions Copyright information © 2020 Springer Nature Switzerland AG About this chapter Cite this chapter Kohl Schwartz, A.S., Imboden, S., von Wolff, M. (2020). Endometriosis. In: von Wolff, M., Nawroth, F. (eds) Fertility Preservation in Oncological and Non-Oncological Diseases. Springer, Cham. https://doi.org/10.1007/978-3-030-47568-0_16 Download citation DOI: https://doi.org/10.1007/978-3-030-47568-0_16 Published: Publisher Name: Springer, Cham Print ISBN: 978-3-030-47567-3 Online ISBN: 978-3-030-47568-0 eBook Packages: MedicineMedicine (R0)

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