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- W4385253210 abstract "Ovarian endometriomas have a negative impact on a patient’s reproductive potential and likely cause a reduction in ovarian reserve. The most commonly employed ovarian reserve parameters are anti-mullerian hormone (AMH) and antral follicular count (AFC). Surgical management options of endometrioma include cystectomy, ablative methods, ethanol sclerotherapy and combined techniques. The optimal surgical approach remains a matter of debate. Our review aimed to summarize the literature on the impact of surgical management of endometrioma on AMH, AFC and fertility outcomes. Cystectomy may reduce recurrence rates and increase chances of spontaneous conception. However, a post-operative reduction in AMH is to be anticipated, albeit there is evidence of recovery during follow-up. The reduction in ovarian reserve is likely multi-factorial. Cystectomy does not appear to significantly reduce, and may even increase, AFC. Ablative methods achieve an ovarian tissue-sparing effect and improved ovarian reserve, compared to cystectomy, has been demonstrated. A single study reported on AMH and AFC post- sclerotherapy and both were significantly reduced. AMH levels may be useful in predicting the chances of conception post-operatively. None of the aforementioned approaches has clearly demonstrated a superiority in terms of overall chances of conception. Surgical management of endometrioma may, overall, improve probability of pregnancy. Evidence on its value before medically-assisted reproduction (MAR) is conflicting, however, a combination of surgery followed by MAR may achieve the optimal fertility outcome. In view of the complexity of available evidence, individualisation of care, combined with optimal surgical technique, is highly recommended." @default.
- W4385253210 created "2023-07-26" @default.
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- W4385253210 date "2023-07-25" @default.
- W4385253210 modified "2023-10-11" @default.
- W4385253210 title "Surgical Management of Ovarian Endometrioma: Impact on Ovarian Reserve Parameters and Reproductive Outcomes" @default.
- W4385253210 doi "https://doi.org/10.20944/preprints202307.1698.v1" @default.
- W4385253210 hasPublicationYear "2023" @default.
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