Impact of Endometriotic Cyst Position on Infertility

Nadya Magunska, Maria Yunakova, Ivan Bochev, Sergei Slavov, I Kostov
In: Proceedings of the Bulgarian Academy of Sciences · 2024 · vol. 77(4) · doi:10.7546/crabs.2024.04.16 · W4395667276
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This study found that spontaneous pregnancy after cystectomy was more frequent in patients with left-sided ovarian endometriomas compared to those with right-sided endometriomas.

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This study evaluated 100 women with unilateral ovarian endometriosis and infertility who underwent ovarian cystectomy, all with at least one patent fallopian tube postoperatively, and followed them for up to one year for spontaneous pregnancy. Participants were categorized by endometrioma laterality (67 left-sided vs 33 right-sided), and groups were reported as similar in age, infertility type, BMI, and cyst size. Spontaneous pregnancy occurred in 28.4% of women with left-sided endometriomas versus 9.1% with right-sided endometriomas, with the left-sided group showing significantly higher pregnancy numbers. A key limitation acknowledged by the authors is that further investigations are needed to more definitively assess how laterality influences infertility; This paper is centrally about endometriosis — it specifically examines how the position of an endometriotic ovarian cyst (left vs right) impacts spontaneous fertility after cystectomy.

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Abstract

Endometriosis is one of the most common benign gynecologic disorders affecting reproductive health. There are many theories regarding how endometriosis affects fertility, but the exact mechanisms are still uncertain. We evaluated 100 patients with unilateral ovarian endometriosis and infertility who underwent ovarian cystectomy. The women had at least one patent tube after surgery and were observed for spontaneous pregnancy for up to one year. Patients were divided into two groups according to the endometrioma position. The first group included 67 women with an endometriotic cyst in the left ovary, and the second group included 33 with an endometrioma in the right ovary. Groups were similar according to age, type of infertility, BMI, and size of the endometrioma. The number of patients was significantly higher in the first group. Spontaneous pregnancy after cystectomy occurred in 28.4% of the patients with an endometrioma in left ovary, and in 9.1% with a right endometriotic cyst. The better results regarding spontaneous conception with a left-sided endometrioma in our study are most likely related to the permeability of the fallopian tubes and adhesions in the Douglas pouch as a result of endometriosis. Further investigations are necessary to assess the influence of the laterality of endometriosis on infertility.
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Impact of Endometriotic Cyst Position on Infertility DOI: https://doi.org/10.7546/CRABS.2024.04.16Keywords: endometriosis surgery, endometriotic cyst, infertilityAbstract Endometriosis is one of the most common benign gynecologic disorders affecting reproductive health. There are many theories regarding how endometriosis affects fertility, but the exact mechanisms are still uncertain. We evaluated 100 patients with unilateral ovarian endometriosis and infertility who underwent ovarian cystectomy. The women had at least one patent tube after surgery and were observed for spontaneous pregnancy for up to one year. Patients were divided into two groups according to the endometrioma position. The first group included 67 women with an endometriotic cyst in the left ovary, and the second group included 33 with an endometrioma in the right ovary. Groups were similar according to age, type of infertility, BMI, and size of the endometrioma. The number of patients was significantly higher in the first group. Spontaneous pregnancy after cystectomy occurred in 28.4% of the patients with an endometrioma in left ovary, and in 9.1% with a right endometriotic cyst. The better results regarding spontaneous conception with a left-sided endometrioma in our study are most likely related to the permeability of the fallopian tubes and adhesions in the Douglas pouch as a result of endometriosis. Further investigations are necessary to assess the influence of the laterality of endometriosis on infertility. Downloads Published How to Cite Issue Section License Copyright (c) 2024 Proceedings of the Bulgarian Academy of SciencesCopyright (c) 2022 Proceedings of the Bulgarian Academy of Sciences Copyright is subject to the protection of the Bulgarian Copyright and Associated Rights Act. The copyright holder of all articles on this site is Proceedings of the Bulgarian Academy of Sciences. If you want to reuse any part of the content, please, contact us.

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