Advertisement

Journal of Assisted Reproduction and Genetics

, Volume 33, Issue 3, pp 317–323 | Cite as

The role of fertility preservation in patients with endometriosis

  • L. Carrillo
  • D. S. Seidman
  • E. Cittadini
  • D. Meirow
Opinions

Abstract

Patients affected with severe endometriosis are at significant risk for ovarian tissue damage, which may lead to infertility, reduced response to ovarian stimulation, and occasionally, premature ovarian failure. The risk for a compromised ovarian reserve in young patients is especially high following repeated surgical intervention and in the presence of bilateral endometriomas. In many cases, enhanced loss of ovarian reserve may also result from the damaging effect of the pathologic process on follicle reservoir even without surgical interventions. Women diagnosed with severe endometriosis and those designated for extensive ovarian surgical intervention are frequently not planning to conceive. In light of recent advances in fertility preservation techniques (FPT), such as oocytes and ovarian tissue freezing, as well as their increasing success rates, we critically evaluate the options for FPT in patients suffering from endometriosis. Personalized counseling should be offered to all patients with endometriosis taking into account age, extent of ovarian involvement, current ovarian reserve, previous and impending surgeries for endometriosis, along with current success rates and possible risks associated with FPT.

Keywords

Fertility preservation Endometriosis Ovarian reserve Ovarian follicles Oocyte-embryo freezing Ovarian tissue cryopreservation 

Notes

Acknowledgment

The authors would like to thank Dr. Moran Shapira for her editing assistance.

Compliance with ethical standards

Source of Funding

None.

References

  1. 1.
    Practice Committee of the American Society for Reproductive Medicine. Mature oocyte cryopreservation: a guideline. Fertil Steril. 2013;99(1):37–43.CrossRefGoogle Scholar
  2. 2.
    Bedoschi G, Oktay K. Current approach to fertility preservation by embryo cryopreservation. Fertil Steril. 2013;99(6):1496–502.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Donnez J, Dolmans MM. Transplantation of ovarian tissue. Best Pract Res Clin Obstet Gynaecol. 2014;28(8):1188–97.CrossRefPubMedGoogle Scholar
  4. 4.
    Meirow D, Rahanani H, Biedermann H. Ovarian tissue cryopreservation and transplantation: a realistic effective technology for fertility preservation methods. Mol Biol. 2014;1154:455–73.Google Scholar
  5. 5.
    Jensen AK, Kristensen SG, Macklon KT, Jeppesen JV, Fedder J, Ernst E, et al. Outcomes of transplantations of cryopreserved ovarian tissue to 41 women in Denmark. Hum Reprod. 2015;30(12):2838–45.CrossRefPubMedGoogle Scholar
  6. 6.
    Practice Committee of the American Society for Reproductive Medicine. Ovarian tissue cryopreservation: a committee opinion. Fertil Steril. 2014;101(5):1237–43.CrossRefGoogle Scholar
  7. 7.
    Jadoul P, Dolmans MM, Donnez J. Fertility preservation in girls during childhood: is it feasible, efficient and safe and to whom should it be proposed? Hum Reprod Update. 2010;16(6):617–30.CrossRefPubMedGoogle Scholar
  8. 8.
    Grynberg M, Bidet M, Benard J, Poulain M, Sonigo C, Cédrin-Durnerin I, Polak M. Fertility preservation in Turner syndrome. Fertil Steril. 2015Google Scholar
  9. 9.
    Pearce CL, Templeman C, Rossing MA, Lee A, Near AM, Webb PM, et al. Association between endometriosis and risk of histological subtypes of ovarian cancer: a pooled analysis of case–control studies. Lancet Oncol. 2012;13:285–94.CrossRefGoogle Scholar
  10. 10.
    Nezhat F, Apostol R, Mahmoud M, El Daouk M. Malignant transformation of endometriosis and its clinical significance. Fertil Steril. 2014;102(2):342–4.CrossRefPubMedGoogle Scholar
  11. 11.
    Hwu YM, Wu FS-Y, Li S-H, Sun F-J, Lin M-H, Lee RK-K. The impact of endometrioma and laparoscopic cystectomy on serum anti-Mullerian hormone levels. Reprod Biol Endocrinol. 2011;9:80.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Guo SW. Recurrence of endometriosis and its control. Hum Reprod Update. 2009;15:441–61.CrossRefPubMedGoogle Scholar
  13. 13.
    Kumbak B, Kahraman S, Karlikaya G, Lacin S, Guney A. In vitro fertilization in normoresponder patients with endometriomas: comparison with basal simple ovarian cysts. Gynecol Obstet Investig. 2008;65(3):212–6.CrossRefGoogle Scholar
  14. 14.
    Kitajima M, Dolmans MM, Donnez O, Masuzaki H, Soares M, Donnez J. Enhanced follicular recruitment and atresia in cortex derived from ovaries with endometriomas. Fertil Steril. 2014;101(4):1031–7.CrossRefPubMedGoogle Scholar
  15. 15.
    Mills M, Rindfuss RR, McDonald P. teVelde E. ESHRE Reproduction and Society Task Force. Why do people postpone parenthood? Reasons and social policy incentives. Hum Reprod Update. 2011;17(6):848–60.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Practice Committee of the American Society for Reproductive Medicine. Endometriosis and infertility: a committee opinion. Fertil Steril. 2012;98:591–8.CrossRefGoogle Scholar
  17. 17.
    Lemos NA, Arbo E, Scalco R, Weiler E, Rosa V, Cuhna-Filho JS. Decreased anti-Mullerian hormone and altered ovarian follicular cohort in infertile patients with mild/minimal endometriosis. Fertil Steril. 2008;89:1064–8.CrossRefPubMedGoogle Scholar
  18. 18.
    Lin XN, Wei ML, Tong XM, Xu WH, Zhou F, Huang QX, et al. Outcome of in vitro fertilization in endometriosis-associated infertility: a 5-year database cohort study. Chin Med J. 2012;25:2688–93.Google Scholar
  19. 19.
    Busacca M, Riparini J, Somigliana E, Oggioni G, Izzo S, Vignali M, et al. Postsurgical ovarian failure after laparoscopic excision of bilateral endometriomas. Am J Obstet Gynecol. 2006;195(2):421–5.CrossRefPubMedGoogle Scholar
  20. 20.
    Coccia ME, Rizzello F, Mariani G, Bulletti C, Palagiano A, Scarselli G. Ovarian surgery for bilateral endometriomas influences age at menopause. Hum Reprod. 2011;26(11):3000–7.CrossRefPubMedGoogle Scholar
  21. 21.
    Roman H, Tarta O, Pura I, Opris I, Bourdel N, Marpeau L, et al. Direct proportional relationship between endometrioma size and ovarian parenchyma inadvertently removed during cystectomy, and its implication on the management of enlarged endometriomas. Hum Reprod. 2010;25:1428–32.CrossRefPubMedGoogle Scholar
  22. 22.
    Biacchiardi CP, Piane LD, Camanni M, Deltetto F, Delpiano EM, Marchino GL, et al. Laparoscopic stripping of endometriomas negatively affects ovarian follicular reserve even if performed by experienced surgeons. Reprod BioMed Online. 2011;23:740–6.CrossRefPubMedGoogle Scholar
  23. 23.
    Tsolakidis D, Pados G, Vavilis D, Athanatos D, Tsalikis T, Giannakou A, et al. The impact on ovarian reserve after laparoscopic ovarian cystectomy versus three-stage management in patients with endometriomas: a prospective randomized study. Fertil Steril. 2010;94:71–7.CrossRefPubMedGoogle Scholar
  24. 24.
    Celik HG, Dogan E, Okyay E, Ulukus C, Saatli B, Uysal S, et al. Effect of laparoscopic excision of endometriomas on ovarian reserve: serial changes in the serum antimullerian hormone levels. Fertil Steril. 2012;97:1472–8.CrossRefPubMedGoogle Scholar
  25. 25.
    Hirokawa W, Iwase A, Goto M, Takikawa S, Nagatomo Y, Nakahara T, et al. The post-operative decline in serum anti-Mullerian hormone correlates with the bilaterality and severity of endometriosis. Hum Reprod. 2011;26(4):904–10.CrossRefPubMedGoogle Scholar
  26. 26.
    Var T, Batioglu S, Tonguc E, Kahyaoglu I. The effect of laparoscopic ovarian cystectomy versus coagulation in bilateral endometriomas on ovarian reserve as determined by antral follicle count and ovarian volume: a prospective randomized study. Fertil Steril. 2011;95:2247–50.CrossRefPubMedGoogle Scholar
  27. 27.
    Li CZ, Liu B, Wen ZQ, Sun Q. The impact of electrocoagulation on ovarian reserve after laparoscopic excision of ovarian cyst: a prospective clinical study of 191 patients. Fertil Steril. 2009;92:1428–35.CrossRefPubMedGoogle Scholar
  28. 28.
    Romualdi D, Franco Zannoni G, Lanzone A, Selvaggi L, Tagliaferri V, Gaetano Vellone V, et al. Follicular loss in endoscopic surgery for ovarian endometriosis: quantitative and qualitative observations. Fertil Steril. 2011;96(2):374–8.CrossRefPubMedGoogle Scholar
  29. 29.
    Tandoi I, Somigliana E, Riparini J, Ronzoni S, Vigano P, Candiani M. High rate of endometriosis recurrence in young women. J Pediatr Adolesc Gynecol. 2011;24(6):376–9.CrossRefPubMedGoogle Scholar
  30. 30.
    Shebl O, Ebner T, Sommergruber M, Sir A, Tews G. Anti Muellerian hormone serum levels in women with endometriosis: a case–control study. Gynecol Endocrinol. 2009;25(11):713–6.CrossRefPubMedGoogle Scholar
  31. 31.
    Ercan CM, Sakinci M, Duru NK, Alanbay I, Karasahin KE, Baser I. Antimullerian hormone levels after laparoscopic endometrioma stripping surgery. Gynecol Endocrinol. 2010;26:468–72.CrossRefPubMedGoogle Scholar
  32. 32.
    Uncu G, Kasapoglu I, Ozerkan K, Seyhan A, Oral Yilmaztepe A, Ata B. Prospective assessment of the impact of endometriomas and their removal on ovarian reserve and determinants of the rate of decline in ovarian reserve. Hum Reprod. 2013;28(8):2140–5.CrossRefPubMedGoogle Scholar
  33. 33.
    Almog B, Shehata F, Sheizaf B, Tulandi T. Effect of different types of ovarian cyst on antral follicle count. Fertil Steril. 2010;94:2338–9.CrossRefPubMedGoogle Scholar
  34. 34.
    Suzuki T, Izumi S, Matsubayashi H, Awaji H, Yoshikata K, Makino T. Impact of ovarian endometrioma on oocytes and pregnancy outcome in vitro fertilization. Fertil Steril. 2005;83:908–13.CrossRefPubMedGoogle Scholar
  35. 35.
    Opøien HK, Fedorak P, Omland AK, Abyholm T, Bjerke S, Ertzeid G, et al. In vitro fertilization is a successful treatment in endometriosis-associated infertility. Fertil Steril. 2012;97(4):912–8.CrossRefPubMedGoogle Scholar
  36. 36.
    Kitajima M, Defrère S, Dolmans MM, Colette S, Squifflet J, Van Langendonckt A, et al. Endometriomas as a possible cause of reduced ovarian reserve in women with endometriosis. Fertil Steril. 2011;96(3):685–91.CrossRefPubMedGoogle Scholar
  37. 37.
    Maneschi F, Marasa L, Incandela S, Mazzarese M, Zupi E. Ovarian cortex surrounding benign neoplasms: a histologic study. Am J Obstet Gynecol. 1993;169(2 Pt 1):388–93.CrossRefPubMedGoogle Scholar
  38. 38.
    Muzii L, Bianchi A, Crocè C, Manci N, Benedetti Panici P. Laparoscopic excision of ovarian cysts: is the stripping technique a tissue sparing procedure? Fertil Steril. 2002;77:609–14.CrossRefPubMedGoogle Scholar
  39. 39.
    Somigliana E, Infantino M, Benedetti F, Arnoldi M, Calanna G, Ragni G. The presence of ovarian endometriomas is associated with a reduced responsiveness to gonadotropins. Fertil Steril. 2006;86(1):192–6.CrossRefPubMedGoogle Scholar
  40. 40.
    Meirow D, Dor J, Kaufman B, Shrim A, Rabinovici J, Schiff E, et al. Cortical fibrosis and blood-vessels damage in human ovaries exposed to chemotherapy. Potential mechanisms of ovarian injury. Hum Reprod. 2007;22(6):1626–33.CrossRefPubMedGoogle Scholar
  41. 41.
    Sanchez AM, Viganò P, Somigliana E, Panina-Bordignon P, Vercellini P, Candiani M. The distinguishing cellular and molecular features of the endometriotic ovarian cyst: from pathophysiology to the potential endometrioma-mediated damage to the ovary. Hum Reprod Update. 2014;20(2):217–30.CrossRefPubMedGoogle Scholar
  42. 42.
    Kalich-Philosoph L, Roness H, Carmely A, Fishel-Bartal M, Ligumsky H, Paglin S, et al. Cyclophosphamide triggers follicle activation and “burnout”; AS101 prevents follicle loss and preserves fertility. Sci Transl Med. 2013;5(185):185ra62.CrossRefPubMedGoogle Scholar
  43. 43.
    Roness H, Gavish Z, Cohen Y, Meirow D. Ovarian follicle burn-out: a universal phenomenon? Cell Cycle. 2013;12(20):3245–6.CrossRefPubMedPubMedCentralGoogle Scholar
  44. 44.
    Muzii L, Marana R, Angioli R, Bianchi A, Cucinella G, Vignali M, et al. Histologic analysis of specimens from laparoscopic endometrioma excision performed by different surgeons: does the surgeon matter? Fertil Steril. 2011;95:2116–9.CrossRefPubMedGoogle Scholar
  45. 45.
    Cobo A, Diaz C. Clinical application of oocyte vitrification: a systematic review and meta-analysis of randomized controlled trials. Fertil Steril. 2011;96(2):277–85.CrossRefPubMedGoogle Scholar
  46. 46.
    D’Hooghe TM, Denys B, Spiessens C, Meuleman C, Debrock S. Is the endometriosis recurrence rate increased after ovarian hyperstimulation? Fertil Steril. 2006;86(2):283–90.CrossRefPubMedGoogle Scholar
  47. 47.
    Benaglia L, Somigliana E, Santi G, Scarduelli C, Ragni G, Fedele L. IVF and endometriosis-related symptom progression: insights from a prospective study. Hum Reprod. 2011;26(9):2368–72.CrossRefPubMedGoogle Scholar
  48. 48.
    Reinblatt SL, Ishai L, Shehata F, Son WY, Tulandi T, Almog B. Effects of ovarian endometrioma on embryo quality. Fertil Steril. 2011;95:2700–2.CrossRefPubMedGoogle Scholar
  49. 49.
    Garcia-Velasco JA, Arici A. Is the endometrium or oocyte/embryo affected in endometriosis? Hum Reprod. 1999;14 Suppl 2:77–89.CrossRefPubMedGoogle Scholar
  50. 50.
    Yaron Y, Peyser MR, Samuel D, Amit A, Lessing JB. Infected endometriotic cysts secondary to oocyte aspiration for in-vitro fertilization. Hum Reprod. 1994;9:1759–60.PubMedGoogle Scholar
  51. 51.
    Elizur SE, Lebovitz O, Weintraub AY, Eisenberg VH, Seidman DS, Goldenberg M, et al. Pelvic inflammatory disease in women with endometriosis is more severe than in those without. Aust N Z J Obstet Gynaecol. 2014;54(2):162–5.CrossRefPubMedGoogle Scholar
  52. 52.
    Cil AP, Bang H, Oktay K. Age-specific probability of live birth with oocyte cryopreservation: an individual patient data meta-analysis. Fertil Steril. 2013;100(2):492–9.CrossRefPubMedPubMedCentralGoogle Scholar
  53. 53.
    Meirow D. Fertility preservation in cancer patients using stored ovarian tissue: clinical aspects. Curr Opin Endocrinol Diabetes Obes. 2008;15(6):536–47.CrossRefPubMedGoogle Scholar
  54. 54.
    Dittrich R, Lotz L, Keck G, Hoffmann I, Mueller A, Beckmann MW, et al. Live birth after ovarian tissue auto-transplantation following overnight transportation before cryopreservation. Fertil Steril. 2012;97(2):387–90.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • L. Carrillo
    • 1
  • D. S. Seidman
    • 2
  • E. Cittadini
    • 1
  • D. Meirow
    • 2
    • 3
  1. 1.Centro di Biologia della Riproduzione (CBR)PalermoItaly
  2. 2.Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
  3. 3.Fertility Preservation Center, IVF Unit, Division of Obstetrics and GynecologyChaim Sheba Medical CenterTel HashomerIsrael

Personalised recommendations