«Reproductive portrait» of infertile patients with endometrioid ovarian cysts

I.Yu. Ershova, K.V. Krasnopolskaya, I.V. Krasnopol’skaya, A.A. Samoilova
In: Russian Bulletin of Obstetrician-Gynecologist · 2023 · vol. 23(5) , pp. 73 · doi:10.17116/rosakush20232305173 · W4387507375
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Abstract

Objective. To compile a generalized «reproductive portrait» of infertile patients with endometrioid ovarian cysts, showing the features of clinical status, which potentially influence the demand for and effectiveness of in vitro fertilization (IVF) program. Material and methods. In 644 infertile patients with ovarian endometriosis included in the IVF program, the features of the detected endometrioid ovarian cysts — ECNs (size, number, location in one or both ovaries, primary or recurrent appearance) and the state of ovarian reserve characterized by the level of antimüllerian hormone and basal number of antral follicles were analyzed. The distribution of patients was studied taking into account the pathogenetic forms of infertility presented in ICD-10, the age distribution of patients, and the frequency of previously performed second surgical excisions of endometriomas due to their recurrences was specified. Results. In 20% of women with endometrioid ovarian cysts the observed infertility was associated only with the endometriosis process without signs allowing to identify the pathogenetic form of infertility according to ICD-10 criteria. In the remaining infertile women with endometrioid ovarian cysts the indications for IVF were associated with diagnostically confirmed mechanisms of infertility, the leading ones being concomitant tubal and male factors. The established situation did not depend on the severity of ovarian lesions with endometrioid process. Conclusion. Most patients with endometrioid ovarian cysts who are referred for IVF need this method of infertility treatment due to the presence of tubal and male factors. Repeated ovarian resections at recurrences of endometrioid cysts are accompanied by significant reduction of ovarian reserve, worsening the prognosis of successful use of IVF with the patient’s own oocytes.

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endometriosisinfertility

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