Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Rangi, Sabrina, Hur, Christine, Richards, Elliott, Falcone, Tommaso
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
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
_version_ 1785072506396213248
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