Features of reproductive potential in patients with extensive endometriosis forms

Aim: to determine the optimal tactics for managing patients with deep infiltrating endometriosis.

and Methods. A prospective cohort clinical trial was conducted with 69 patients examined following surgical treatment for extensive infiltrating endometriosis and 3-month-long anti-relapse therapy with gonadotropin-releasing hormone agonists. Reproductive potential was assessed based on quantitating anti-Müllerian hormone (AMH) before and 6 months post-surgery, recording cases with/without onset of spontaneous pregnancy within 1 year. Results. While comparatively analyzing AMH level in preand postoperative period revealed its decline in 51.8 % by average 0.152 ng/ml; the smallest reduction was found in women aged 28.5 to 33.5 years, regardless of the extent of surgical treatment. Pregnancy occurred in 10 of 43 planning women (average age 36,0 [32,0–42,5] years): 7 patients underwent ovarian interventions, 3 – surgical treatment for endometriosis of other localizations. Conclusion. The data obtained evidence that subject’s age plays a decisive role in maintaining reproductive potential and a need for a differentiated approach in developing individual tactics for management and treatment of patients with deep infiltrating endometriosis, taking into account age, localization of endometriosis and reproductive plans.

About the Authors D. M. KalimatovaRussian Federation Donna M. Kalimatova - MD, PhD. 1 Ostrovityanova Str., Moscow 117513 Yu. E. Dobrokhotova Russian Federation Yulia E. Dobrokhotova - MD, Dr Med Sci, Prof. 1 Ostrovityanova Str., Moscow 117513 M. D. Kazieva Russian Federation Milana D. Kazieva - MD. 1 Ostrovityanova Str., Moscow 117513 I. Yu. Ilyina Russian Federation Irina Yu. Ilyina - MD, Dr Med Sci, Prof. 1 Ostrovityanova Str., Moscow 117513 J. M. Ibragimova Russian Federation Jamilya M. Ibragimova - MD, PhD. 1 Ostrovityanova Str., Moscow 117513

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(In Russ.). https://doi.org/10.23946/25000764-2024-9-3-66-73. 28. Fedorov A.A., Popov A.A., Krasnopol’skaya K.V. et al. Effect of surgical treatment on fertility in patients with endometrioid cysts. [ [Vliyanie hirurgicheskogo lecheniya na fertil'nost' u pacientok s endometrioidnymi kistami]. Rossijskij vestnik akushera-ginekologa. 2022;22(5):56–61. (In Russ.). https://doi.org/10.17116/rosakush20222205156. What is already known about this subject? ► Endometriosis of various locations causes infertility in 40 % of patients. The effectiveness of isolated drug therapy remains low. ► The degree of invasion of endometriosis foci is a determining factor in choosing an extent of surgical treatment. ► Radical surgical treatment of endometriosis in combination with drug therapy and assisted reproductive technologies increases the chances of pregnancy and its successful outcome. What are the new findings? ► An inverse relationship between patients’ age and anti-Müllerian hormone level has been established. ► Higher frequency of implemented patient reproductive plans was demonstrated while performing ovarian interventions due to ovarian endometriosis. ► The discriminatory ability of patient’s age in predicting ovarian endometriosis has been revealed. How might it impact on clinical practice in the foreseeable future? ► The study results may contribute to increasing clinical treatment effectiveness for patients with endometriosis. ► An opportunity for predicting probability of age-related reproductive function in patients with endometriosis and the presence of ovarian endometriosis lesions is presented. ► Conducting comprehensive treatment of endometriosis (surgical and medical) will improve effectiveness of infertility treatment in this group of patients. Review For citations: Kalimatova D.M., Dobrokhotova Yu.E., Kazieva M.D., Ilyina I.Yu., Ibragimova J.M. Features of reproductive potential in patients with extensive endometriosis forms. Obstetrics, Gynecology and Reproduction. 2026;20(1):91-101. (In Russ.) https://doi.org/10.17749/2313-7347/ob.gyn.rep.2026.676 JATS XML This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.