Fertility preservation in women with endometriosis: for all, for some, for none?

Edgardo Somigliana, Paola Viganò, Francesca Filippi, Enrico Papaleo, Laura Benaglia, Massimo Candiani, Paolo Vercellini
Human Reproduction · 2015 · vol. 30(6) , pp. 1280–1286 · doi:10.1093/humrep/dev078 · PMID:25883035 · W2035183035
article OA: bronze CC0 ⤵ 75 in-corpus citations
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Fertility preservation may benefit women with endometriosis, especially those with bilateral endometriomas or recurrent disease, but routine clinical use is not yet supported due to insufficient data and cost-utility analyses.

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Abstract

The increasing confidence with the techniques of oocyte and ovarian cortex freezing has prompted their potential use for patient categories other than those at risk of early menopause due to cancer treatments. Women affected by every iatrogenic or pathologic condition known to compromise ovarian function severely have been considered as potential candidates for fertility preservation. Among them, women with endometriosis may represent a particularly suitable group since they are at increased risk of premature ovarian exhaustion and about half of them will experience infertility. Based on the currently available notions on the intricate relationships between endometriosis, infertility and damage to the ovarian reserve, we speculate that fertility preservation may be of interest for women with endometriosis, in particular for those with bilateral unoperated endometriomas and for those who previously had excision of unilateral endometriomas and require surgery for a contralateral recurrence. Young age at diagnosis may be an independent but pivotal additional factor to be taken into consideration in the balance of the pros and cons of fertility preservation. On the other hand, we argue against the introduction of fertility preservation for endometriosis in routine clinical practice. To date, only few cases have been reported and there are insufficient data for robust cost-utility analyses. It is noteworthy that endometriosis is a relatively common disease and systematically including affected women in a fertility preservation program would have profound clinical, logistic and financial effects. More clinical data and in-depth economic analysis are imperative prior to recommending its routine use.

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Condition tags

mesh:D004715endometriosisinfertility

MeSH descriptors

Endometriosis Fertility Preservation Adult Clinical Decision-Making Cost-Benefit Analysis Endometriosis Female Fertility Preservation Humans Infertility, Female Ovarian Reserve

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (70)

Cited by (50)

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