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Fertility Preservation in Women with Endometriosis
Several mechanisms have been implicated in the pathogenesis of endometriosis-related infertility. For patients considering surgery, the risk of iatrogenic injury is among the most important factors in the context of fertility preservation, along with age and individual reproductive goals. In the cas...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10342469/ https://www.ncbi.nlm.nih.gov/pubmed/37445365 http://dx.doi.org/10.3390/jcm12134331 |
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author | Rangi, Sabrina Hur, Christine Richards, Elliott Falcone, Tommaso |
author_facet | Rangi, Sabrina Hur, Christine Richards, Elliott Falcone, Tommaso |
author_sort | Rangi, Sabrina |
collection | PubMed |
description | Several mechanisms have been implicated in the pathogenesis of endometriosis-related infertility. For patients considering surgery, the risk of iatrogenic injury is among the most important factors in the context of fertility preservation, along with age and individual reproductive goals. In the case of endometrioma excision, evidence overwhelmingly demonstrates the negative impact of surgery on ovarian reserve, with significant reductions in antimullerian hormone (up to 30% in unilateral versus up to 44% in bilateral endometriomas). The surgical endometriosis patient should be thoroughly counseled regarding fertility preservation and discussion should include tissue, embryo, and oocyte cryopreservation options. For the latter, data support cryopreservation of 10–15 oocytes in women ≤35 years and over 20 for those >35 years for a realistic chance to achieve one or more live births. When performing surgical interventions for endometriosis, reproductive surgeons should employ fertility-conserving surgical methods to reduce the likelihood of postoperative iatrogenic diminished ovarian reserve. |
format | Online Article Text |
id | pubmed-10342469 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-103424692023-07-14 Fertility Preservation in Women with Endometriosis Rangi, Sabrina Hur, Christine Richards, Elliott Falcone, Tommaso J Clin Med Review Several mechanisms have been implicated in the pathogenesis of endometriosis-related infertility. For patients considering surgery, the risk of iatrogenic injury is among the most important factors in the context of fertility preservation, along with age and individual reproductive goals. In the case of endometrioma excision, evidence overwhelmingly demonstrates the negative impact of surgery on ovarian reserve, with significant reductions in antimullerian hormone (up to 30% in unilateral versus up to 44% in bilateral endometriomas). The surgical endometriosis patient should be thoroughly counseled regarding fertility preservation and discussion should include tissue, embryo, and oocyte cryopreservation options. For the latter, data support cryopreservation of 10–15 oocytes in women ≤35 years and over 20 for those >35 years for a realistic chance to achieve one or more live births. When performing surgical interventions for endometriosis, reproductive surgeons should employ fertility-conserving surgical methods to reduce the likelihood of postoperative iatrogenic diminished ovarian reserve. MDPI 2023-06-28 /pmc/articles/PMC10342469/ /pubmed/37445365 http://dx.doi.org/10.3390/jcm12134331 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Rangi, Sabrina Hur, Christine Richards, Elliott Falcone, Tommaso Fertility Preservation in Women with Endometriosis |
title | Fertility Preservation in Women with Endometriosis |
title_full | Fertility Preservation in Women with Endometriosis |
title_fullStr | Fertility Preservation in Women with Endometriosis |
title_full_unstemmed | Fertility Preservation in Women with Endometriosis |
title_short | Fertility Preservation in Women with Endometriosis |
title_sort | fertility preservation in women with endometriosis |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10342469/ https://www.ncbi.nlm.nih.gov/pubmed/37445365 http://dx.doi.org/10.3390/jcm12134331 |
work_keys_str_mv | AT rangisabrina fertilitypreservationinwomenwithendometriosis AT hurchristine fertilitypreservationinwomenwithendometriosis AT richardselliott fertilitypreservationinwomenwithendometriosis AT falconetommaso fertilitypreservationinwomenwithendometriosis |