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Tief infiltrierende Endometriose – Ist eine operative Therapie vor IVF erforderlich?

Deep infiltrating endometriosis—Is there a role for surgery before IVF?

  • Gynäkologie aktuell
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Zusammenfassung

Die tief infiltrierende Endometriose (TIE) ist mit Fertilitätsstörungen assoziiert, die operative Therapie mit teils schwerwiegenden Komplikationen. Zur Verbesserung der Fertilität stehen Maßnahmen der assistierten Reproduktion zur Verfügung. Bei eingeschränkter Datenlage scheint die Operation bei TIE ebenfalls eine Verbesserung der Fertilität zu bewirken. Erreichbar sind insbesondere die Möglichkeit einer spontanen Schwangerschaft, einer Schwangerschaft nach frustraner reproduktionsmedizinischer Behandlung, aber auch die zusätzliche Verbesserung der Fertilität trotz Durchführung von Maßnahmen der assistierten Reproduktion. Bei der Behandlungsplanung muss auch das Vorhandensein einer Adenomyosis berücksichtigt werden. Das Vorgehen bei TIE und Infertilität muss individuell geplant werden.

Abstract

Deep infiltrating endometriosis (DIE) is associated with disorders of fertility. The operative treatment for DIE is sometimes associated with severe complications. Assisted reproductive technology (ART) can be used to improve fertility. According to the limited data available surgery for DIE also seems to result in improvement of fertility. Operative treatment particularly achieves the possibility of a spontaneous conception, pregnancy after unsuccessful treatment with ART and also the additional improvement of fertility despite carrying out measures for assisted reproduction. The treatment planning must also take the presence of adenomyosis into consideration. The approach in cases of DIE and infertility must be individually planned.

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  1. Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Deutschland

    Sebastian D. Schäfer

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Tanja Fehm, Düsseldorf

Ludwig Kiesel, Münster

Rainer Kimmig, Essen

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Schäfer, S.D. Tief infiltrierende Endometriose – Ist eine operative Therapie vor IVF erforderlich?. Gynäkologe 55, 279–287 (2022). https://doi.org/10.1007/s00129-022-04915-8

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