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Endometrioma and assisted reproductive technology: a review

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Abstract

Purpose

Endometriomas are a common cause of infertility necessitating assisted reproductive technology (ART). It had been previously thought that surgical removal of the endometriomas prior to ART would improve reproductive outcomes, but recent data suggests that surgical cystectomy might affect the ovarian reserve, decreasing the chances of ART success. The aim of this article is to review the literature on the effects of endometrioma surgery on ART outcomes providing an overview of the current evidence and assessing the need for further studies.

Methods

A literature search was performed using PubMed and MEDLINE databases to identify studies that discuss endometriomas and assisted reproductive technology before versus after surgery.

Results

In women with an endometrioma requiring ART, growing evidence suggests that surgery might result in damage to the ovarian reserve and further decrease chances of fertility. However, pregnancy rates, implantation rates, fertilization rates, and live birth rates seemed to be consistently similar across both groups.

Conclusion

The current evidence is inconclusive on whether endometriomas should be surgically removed prior to ART. Further large randomized controlled trials are needed for a definite answer, and until then, management should be individualized.

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Author information

Authors and Affiliations

  1. Department of Pathology, Wayne State University, Detroit, MI, USA

    Mira H. Kheil

  2. Virginia Center for Reproductive Medicine, Reston, VA, USA

    Fady I. Sharara

  3. Department of Obstetrics and Gynecology, The George Washington University Hospital, Washington, DC, USA

    Fady I. Sharara, Sara Rahman & Gaby Moawad

  4. Department of Obstetrics and Gynecology, Foch Hospital, Suresnes, Faculty of Medicine, Paris Quest (UVSQ), Suresnes, France

    Jean Marc Ayoubi

Authors
  1. Mira H. Kheil
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  2. Fady I. Sharara
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  3. Jean Marc Ayoubi
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  4. Sara Rahman
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  5. Gaby Moawad
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All authors contributed equally to this review paper.

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Correspondence to Gaby Moawad.

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Kheil, M.H., Sharara, F.I., Ayoubi, J.M. et al. Endometrioma and assisted reproductive technology: a review. J Assist Reprod Genet 39, 283–290 (2022). https://doi.org/10.1007/s10815-022-02403-5

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  • DOI: https://doi.org/10.1007/s10815-022-02403-5

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