Endometrioma: Contemporary Approach to Diagnosis and Management

M. Billow, Shobha Sridhar, S. Sridhar, Gabrielle Mintz, G Mintz
Seminars in reproductive medicine · 2025 · vol. 43(03) , pp. 221–230 · doi:10.1055/s-0045-1810430 · PMID:40749701 · W4412835612
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This review details the diagnosis and management of ovarian endometriomas, discussing imaging techniques, treatment options balancing symptom relief and fertility, and emerging innovations to preserve ovarian function.

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

This paper is a contemporary review of ovarian endometriomas, describing how they present clinically and how they are diagnosed and managed in women, with emphasis on transvaginal ultrasound and magnetic resonance imaging and on aligning treatment with goals such as symptom relief, fertility preservation, and long-term ovarian function. It reports that advanced imaging improves diagnostic accuracy and that laparoscopic cystectomy is considered the gold standard for pain, infertility, or concerning imaging findings, while noting the acknowledged risk of reduced ovarian reserve. The review also discusses management ranging from surveillance in asymptomatic cases to medical therapy, and notes emerging evidence that conservative surgical techniques plus postoperative hormonal therapy may reduce recurrence, with an explicit caveat that future research is needed on biomarkers, noninvasive diagnostic tools, and ovarian-sparing surgical optimization. This paper is centrally about endometriosis — ovarian endometrioma diagnosis and management and their links to pelvic pathology including deep endometriosis and adenomyosis.

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Abstract

Endometriomas affect up to 44% of women with endometriosis and are associated with chronic pelvic pain, infertility, and reduced ovarian reserve. Diagnosis and management are clinically challenging, requiring a nuanced understanding of imaging, clinical presentation, and patient goals. This review offers a comprehensive overview of the diagnosis and management of ovarian endometrioma, with a focus on clinical presentation, advanced diagnostic imaging, and treatment strategies. It addresses the complex balance between symptom relief, disease progression, fertility preservation, and long-term ovarian function, while also exploring emerging innovations in care. Endometriomas are often associated with significant pelvic pathology, including deep endometriosis and adenomyosis. Advanced imaging modalities, such as transvaginal ultrasound and magnetic resonance imaging, have significantly improved diagnostic accuracy. Management strategies range from surveillance in asymptomatic patients to medical therapy for symptom control. Surgical options of laparoscopic cystectomy remain the gold standard for patients with pain, infertility, or concerning imaging findings, but do carry the risk of affecting ovarian reserve. Emerging evidence suggests that conservative surgical techniques and postoperative hormonal therapy may reduce recurrence rates. Endometriomas represent a complex gynecological condition requiring individualized management strategies. Future research should focus on biomarkers for diagnosis and recurrence prediction, refining noninvasive diagnostic tools, and optimizing surgical techniques to minimize ovarian damage.

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Outcome instruments

Enzian

Condition tags

mesh:D004715mesh:D017699endometriosisadenomyosisendometriomachronic_pelvic_paininfertility

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis

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 (84)

Source provenance

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License: CC0 · commercial use OK