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Impact of Endometrioma Surgery on Ovarian Reserve

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Endometriosis Pathogenesis, Clinical Impact and Management

Part of the book series: ISGE Series ((ISGE))

Abstract

Currently, ovarian endometrioma (OMA) laparoscopic excision using the stripping technique is considered the gold standard among OMA surgical treatments. Excisional surgery allows for pain resolution, a high rate of spontaneous pregnancies and a lower recurrence rate of ovarian cysts when compared to drainage and ablation techniques. Because the follicles are tightly attached to the endometrioma’s pseudo capsule, risking being removed during the cystectomy or damaged by coagulation, a cystectomy may cause healthy loss of ovarian tissue, thus reducing the ovarian reserve and fertility. For this reason, new methods have been developed to be effective and feasible, but also safe, with less impact on the ovarian reserve. In this chapter, we focus on the latest procedures, which may use different energy sources, such as CO2 laser, argon plasma or diode laser. Various studies have demonstrated the pros and cons of each method, including in terms of conservation of the ovarian reserve, by analysing two main markers: the anti-Mullerian hormone (AMH) and the antral follicular count (AFC).

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Authors and Affiliations

  1. Department of Surgical Sciences, University of Cagliari, Cagliari, Italy

    Stefano Angioni, Francesco Scicchitano, Marco Sigilli, Antonio G. Succu, Stefania Saponara & Maurizio N. D’Alterio

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  1. Stefano Angioni
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  2. Francesco Scicchitano
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  3. Marco Sigilli
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  4. Antonio G. Succu
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  5. Stefania Saponara
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  6. Maurizio N. D’Alterio
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Editors and Affiliations

  1. International Society of Gynecological Endocrinology, Pisa, Italy

    Andrea R. Genazzani

  2. Centre hospitalier régional de la Citad, Liège, Belgium

    Michelle Nisolle

  3. Obstetrics and Gynecology Division, University of Florence, Firenze, Italy

    Felice Petraglia

  4. Obstetrics & Gynecology Research Network, University of Utah, Salt Lake City, UT, USA

    Robert N. Taylor

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Angioni, S., Scicchitano, F., Sigilli, M., Succu, A.G., Saponara, S., D’Alterio, M.N. (2021). Impact of Endometrioma Surgery on Ovarian Reserve. In: Genazzani, A.R., Nisolle, M., Petraglia, F., Taylor, R.N. (eds) Endometriosis Pathogenesis, Clinical Impact and Management. ISGE Series. Springer, Cham. https://doi.org/10.1007/978-3-030-57866-4_8

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  • DOI: https://doi.org/10.1007/978-3-030-57866-4_8

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