The Impact of Endometriosis and Its Treatment on Ovarian Reserve

Ayse Seyhan, Ayşe Seyhan, Baris Ata, Barış Ata, Gürkan Uncu
Seminars in reproductive medicine · 2015 · vol. 33(06) , pp. 422–428 · doi:10.1055/s-0035-1567820 · PMID:26594869 · W2338788197
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Endometriosis and surgical treatment, especially endometriomas and bipolar cauterization, decrease ovarian reserve markers like AMH, necessitating informed fertility preservation discussions.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This paper reviews and synthesizes evidence on how endometriosis and its surgical treatments affect quantitative ovarian reserve, focusing on biomarkers and outcomes such as anti-Müllerian hormone (AMH) and antral follicle count in women of reproductive age, including those with ovarian endometriomas. It reports that women with endometrioma have decreased serum AMH compared with healthy controls, that AMH further declines after surgical excision with a decline described as seemingly permanent, and that bipolar cauterization of the ovary may contribute to ovarian damage; it also notes limited information on extraovarian endometriosis. The major caveat highlighted is that information is limited for some disease locations and treatment contexts, and that antral follicle count may be less reliable in the presence of endometriomas, implying biomarker interpretation challenges. This paper is centrally about endometriosis — specifically, how endometriosis and its surgical treatments (especially endometrioma excision methods) impact ovarian reserve as measured by AMH and related assessments.

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Abstract

Endometriosis is a chronic disease mostly affecting women at reproductive age. There is a clear association between endometriosis and infertility; however, exact mechanisms are unknown. Some evidence suggests an adverse effect on oocytes. Endometriosis and its surgical treatment can affect quantitative ovarian reserve as well. In the presence of endometriomas, serum level of anti-Müllerian hormone (AMH) seems a more reliable marker of ovarian reserve than antral follicle count. Women with endometrioma have decreased serum AMH levels as compared with healthy controls. This is further declined after surgical excision, and the decline seems permanent. Bipolar cauterization of the ovary seems to be playing a role on ovarian damage. Extraovarian endometriosis and its surgical treatment can also be associated with decreased ovarian reserve, but there is limited information. Patients with endometriosis should be informed about fertility preservation options, especially in the presence of bilateral endometriomas or prior to surgery.

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Condition tags

mesh:D004715endometriosisendometriomainfertility

MeSH descriptors

Endometriosis Endometriosis Endometrium Infertility, Female Oocytes Ovarian Reserve Ovary Ovulation Anti-Mullerian Hormone Anti-Mullerian Hormone Biomarkers Biomarkers Endometriosis Endometriosis Endometriosis Endometrium Endometrium Endometrium Female Fertility Preservation

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