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An Update on Surgical versus Expectant Management of Ovarian Endometriomas in Infertile Women

Ovarian endometriomas are a common manifestation of endometriosis that can represent a more severe stage of the disease. There is much debate over the treatment of these cysts in infertile women, particularly before use of assisted reproductive technologies. Evidence exists that supports surgical ex...

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Detalles Bibliográficos
Autores principales: Keyhan, Sanaz, Hughes, Claude, Price, Thomas, Muasher, Suheil
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4512511/
https://www.ncbi.nlm.nih.gov/pubmed/26240817
http://dx.doi.org/10.1155/2015/204792
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author Keyhan, Sanaz
Hughes, Claude
Price, Thomas
Muasher, Suheil
author_facet Keyhan, Sanaz
Hughes, Claude
Price, Thomas
Muasher, Suheil
author_sort Keyhan, Sanaz
collection PubMed
description Ovarian endometriomas are a common manifestation of endometriosis that can represent a more severe stage of the disease. There is much debate over the treatment of these cysts in infertile women, particularly before use of assisted reproductive technologies. Evidence exists that supports surgical excision of ovarian endometriomas, as well as evidence that cautions against surgical intervention. Certain factors need to be examined closely before proceeding with surgery or continuing with expectant management. These include the patient's symptoms, age, ovarian reserve, size and laterality of the cyst, prior surgical treatment, and level of suspicion for malignancy. The most recent evidence appears to suggest that certain patient profiles may benefit from proceeding directly to in vitro fertilization (IVF). These include symptomatic infertile patients, especially those that are older, those that have diminished ovarian reserve, those that have bilateral endometriomas, or those that have had prior surgical treatment. Although endometriomas can be detrimental to the ovarian reserve, surgical therapy may further lower a woman's ovarian reserve. Nevertheless, the presence of an endometrioma does not appear to adversely affect IVF outcomes, and surgical excision of endometriomas does not appear to improve IVF outcomes. Regardless of treatment plan, infertile patients with endometriomas must be counseled appropriately before choosing either treatment path.
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spelling pubmed-45125112015-08-03 An Update on Surgical versus Expectant Management of Ovarian Endometriomas in Infertile Women Keyhan, Sanaz Hughes, Claude Price, Thomas Muasher, Suheil Biomed Res Int Review Article Ovarian endometriomas are a common manifestation of endometriosis that can represent a more severe stage of the disease. There is much debate over the treatment of these cysts in infertile women, particularly before use of assisted reproductive technologies. Evidence exists that supports surgical excision of ovarian endometriomas, as well as evidence that cautions against surgical intervention. Certain factors need to be examined closely before proceeding with surgery or continuing with expectant management. These include the patient's symptoms, age, ovarian reserve, size and laterality of the cyst, prior surgical treatment, and level of suspicion for malignancy. The most recent evidence appears to suggest that certain patient profiles may benefit from proceeding directly to in vitro fertilization (IVF). These include symptomatic infertile patients, especially those that are older, those that have diminished ovarian reserve, those that have bilateral endometriomas, or those that have had prior surgical treatment. Although endometriomas can be detrimental to the ovarian reserve, surgical therapy may further lower a woman's ovarian reserve. Nevertheless, the presence of an endometrioma does not appear to adversely affect IVF outcomes, and surgical excision of endometriomas does not appear to improve IVF outcomes. Regardless of treatment plan, infertile patients with endometriomas must be counseled appropriately before choosing either treatment path. Hindawi Publishing Corporation 2015 2015-07-09 /pmc/articles/PMC4512511/ /pubmed/26240817 http://dx.doi.org/10.1155/2015/204792 Text en Copyright © 2015 Sanaz Keyhan et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Keyhan, Sanaz
Hughes, Claude
Price, Thomas
Muasher, Suheil
An Update on Surgical versus Expectant Management of Ovarian Endometriomas in Infertile Women
title An Update on Surgical versus Expectant Management of Ovarian Endometriomas in Infertile Women
title_full An Update on Surgical versus Expectant Management of Ovarian Endometriomas in Infertile Women
title_fullStr An Update on Surgical versus Expectant Management of Ovarian Endometriomas in Infertile Women
title_full_unstemmed An Update on Surgical versus Expectant Management of Ovarian Endometriomas in Infertile Women
title_short An Update on Surgical versus Expectant Management of Ovarian Endometriomas in Infertile Women
title_sort update on surgical versus expectant management of ovarian endometriomas in infertile women
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4512511/
https://www.ncbi.nlm.nih.gov/pubmed/26240817
http://dx.doi.org/10.1155/2015/204792
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