Fertility preservation in women with ovarian endometriosis

Jacques Donnez
In: Frontiers in Bioscience · 2012 · vol. E4(5) , pp. 1654–1662 · doi:10.2741/e487 · W4231272767
article OA: closed CC0 ⤵ 12 in-corpus citations
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This review focuses on fertility preservation in women with severe ovarian endometriosis, emphasizing that experienced surgeons should aim to preserve ovarian tissue during endometrioma cystectomy to improve future fertility.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This review article focuses on fertility preservation strategies in women with severe ovarian endometriosis, describing how endometriosis is managed across objectives including fertility preservation, pain reduction, and delaying recurrence. It summarizes evidence that, in moderate and severe disease, medico-surgical management remains a standard approach, while reporting that laparoscopic cystectomy for endometriomas is associated with low ovarian reserve, attributed to excision of normal ovarian tissue along with the cyst wall. A key caveat is that the paper synthesizes published reports rather than presenting new patient-level outcomes, and it emphasizes the need for experienced surgeons to optimize ovarian tissue preservation. This paper is centrally about endometriosis — it specifically addresses fertility preservation in women with ovarian (endometriosis-related) endometriomas and ovarian reserve impacts of cystectomy.

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Abstract

Endometriosis is one of the most frequently encountered benign diseases in gynecology. Complete resolution of endometriosis is not yet possible, but therapy has essentially three main objectives: (1) to preserve and improve fertility, (2) to reduce pain, and (3) to delay recurrence for as long as possible. The aim of this paper is to focus on fertility preservation in women with severe endometriosis. In moderate and severe endometriosis, a medico-surgical approach remains the gold standard, but more and more papers are reporting a low ovarian reserve after laparoscopic cystectomy for endometriomas. Indeed, very frequently, normal ovarian tissue is excised together with the endometrioma wall. Ovarian surgery in endometriosis patients should therefore be performed by experienced surgeons in order to both preserve and improve fertility. Preservation of ovarian tissue should be considered in all patients at serious risk of future fertility impairment, particularly before any treatment likely to result in ovarian endometriosis recurrence and/or premature ovarian failure.

Keywords

- Ovary - Ovarian Endometriosis - Endometrioma - Fertility Preservation - Cryopreservation - Ovarian Cortex - Review

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endometriosis

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