Endometriose und Kinderwunsch – was nun?

Zusammenfassung Patientinnen mit Endometriose sind neben ihren chronischen Schmerzen häufig mit ungewollter Kinderlosigkeit konfrontiert. Allerdings verbessert sich die Chance auf Eintritt einer spontanen Schwangerschaft nach einer Sanierungsoperation in den ersten Monaten deutlich, v. a. im ASRM(American Society for Reproductive Medicine)-Stadium I–II. Eine Operation bei ausgedehnter Endometriose oder DIE („deep infiltrating endometriosis“) sollte weiterhin durch die Schmerzsymptomatik geleitet sein. Vor allem Operationen am Ovar führen zu einer reduzierten ovariellen Reserve. Daher sollte die Indikation kritisch gestellt werden, insbesondere beim Rezidiv. Bei Patientinnen über 35 Jahren und Endometriose sollte zügig eine Mitbetreuung durch einen Reproduktionsmediziner erfolgen. Abstract Female patients with endometriosis are often confronted with fertility problems besides their chronic pain; however, the chances of becoming pregnant are significantly increased in the first months after surgical removal of the lesions, especially in patients with American Society for Reproductive Medicine (ASRM) stages I–II. Surgery for extensive endometriosis or deep infiltrating endometriosis (DIE) should still be guided by the symptoms of pain. Surgery on the ovaries, in particular, leads to a reduction of the ovarian reserve; therefore, the indication and decision for surgery should be critically discussed, particularly in the case of recurrent disease. Patients over 35 years old with endometriosis should seek counseling by a specialist in reproductive medicine without delay. Literatur Soriano D, Adler I, Bouaziz J et al (2016) Fertility outcome of laparoscopic treatment in patients with severe endometriosis and repeated in vitro fertilization failures. 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Jbra Assist Reprod 21(2):120–125 Author information Authors and Affiliations Corresponding author Ethics declarations Interessenkonflikt I. Beyer, A.P. Bielfeld, J.-S. Krüssel und T. Fehm geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren. Rights and permissions About this article Cite this article Beyer, I., Bielfeld, A.P., Krüssel, JS. et al. Endometriose und Kinderwunsch – was nun?. Gynäkologe 50, 948–952 (2017). https://doi.org/10.1007/s00129-017-4161-9 Published: Issue date: DOI: https://doi.org/10.1007/s00129-017-4161-9