• Ciążę u pacjentek z endometriozą można uzyskać tylko wtedy, kiedy są obecne pęcherzyki jajnikowe.
  • Lekarz podejmujący decyzję o sposobie postępowania powinien dokładnie ocenić sytuację kliniczną i przedstawić pacjentce spersonalizowane plany leczenia z uwzględnieniem zalet i wad każdej metody.
  • Lekarz powinien wspólnie z parą zdecydować o sposobie leczenia niepłodności.

ABSTRACT

Treatment approaches to endometriosis-associated infertility

Endometriosis is a well–known cause of infertility characterized by the development of endometrial tissue outside the uterus that induces a chronic inflammatory reaction. Surgical removal of endometriosis improves the chances of conceiving naturally. However, resection of endometriotic cysts leads to ovarian injury and the deterioration of ovarian reserve. The benefit of surgery for reproductive performance is limited. Today ART is commonly the primary option to be considered in women whose infertility is associated with endometriosis. Patients should receive full information about the benefits and disadvantages of each of the proposed treatment options.

Piśmiennictwo

1. Eisenberg VH, Weil C, Chodick G, et al. Epidemiology of endometriosis: a large population-based database study from a healthcare provider with 2 million members. BJOG 2018;125(1):55-62

2. Adamson GD. Diagnosis and clinical presentation of endometriosis. Am J Obstet Gynecol 1990;162(2):568-9

3. de Ziegler D, Pirtea P, Carbonnel M, et al. Assisted reproduction in endometriosis. Best Pract Res Clin Endocrinol Metab 2019;33(1):47-59

4. Somigliana E, Vigano P, Benaglia L, et al. Management of endometriosis in the infertile patient. Semin Reprod Med 2017;35(1):31-7

5. Bazot M, Daraï E. Diagnosis of deep endometriosis: clinical examination, ultrasonography, magnetic resonance imaging and other techniques. Fertil Steril 2017;108(6):886-94

6. González-Comadran M, Schwarze JE, Zegers-Hochschild F, et al. The impact of endometriosis on the outcome of Assisted Reproductive Technology. Reprod Biol Endocrinol 2017;15(1):8

7. Hamdan M, Dunselman G, Li TC, et al. The impact of endometrioma on IVF/ICSI outcomes: a systematic review and metaanalysis. Hum Reprod Update 2015;21(6):809-25

8. Vercellini P, Somigliana E, Vigano P, et al. Surgery for endometriosis-associated infertility: a pragmatic approach. Hum Reprod 2009;24(2):254-69

9. Benaglia L, Castiglioni M, Paffoni A, et al. Is endometrioma-associated damage to ovarian reserve progressive? Insights from IVF cycles. Eur J Obstet Gynecol Reprod Biol 2017;217:101-5

10. Senapati S, Sammel MD, Morse C, et al. Impact of endometriosis on in vitro fertilization outcomes: an evaluation of the society for assisted reproductive technologies database. Fertil Steril 2016;106(1):164-71

11. Benaglia L, Candotti G, Busnelli A, et al. Antral follicle count as a predictor of ovarian responsiveness in women with endometriomas or with a history of surgery for endometriomas. Fertil Steril 2015;103(6):1544-50.e1-3

12. Chen Y, Pei H, Chang Y, et al. The impact of endometrioma and laparoscopic cystectomy on ovarian reserve and the exploration of related factors assessed by serum anti-Mullerian hormone: a prospective cohort study. J Ovarian Res 2014;7:108

13. Streuli I, de Ziegler D, Gayet V, et al. In women with endometriosis anti-Mullerian hormone levels are decreased only in those with previous endometrioma surgery. Hum Reprod 2012;27(11):3294-303

14. Somigliana E, Arnoldi M, Benaglia L, et al. IVF-ICSI outcome in women operated on for bilateral endometriomas. Hum Reprod 2008;23(7):1526-30

15. Goodman LR, Goldberg JM, Flyckt RL, et al. Effect of surgery on ovarian reserve in women with endometriomas, endometriosis and controls. Am J Obstet Gynecol 2016;215(5):589.e1-6

16. Saito N, Okuda K, Yuguchi H, et al. Compared with cystectomy, is ovarian vaporization of endometriotic cysts truly more effective in maintaining ovarian reserve? J Minim Invasive Gynecol 2014;21(5):804-10

17. Garcia-Velasco JA, Mahutte NG, Corona J, et al. Removal of endometriomas before in vitro fertilization does not improve fertility outcomes: a matched, case-control study. Fertil Steril 2004;81(5):1194-7

18. Donnez J, Dolmans MM. Fertility preservation in women. N Engl J Med 2018;378:400-1

19. Surrey ES, Silverberg KM, Surrey MW, et al. Effect of prolonged gonadotropin-releasing hormone agonist therapy on the outcome of in vitro fertilization-embryo transfer in patients with endometriosis. Fertil Steril 2002;78(4):699-704

20. Sallam HN, Garcia-Velasco JA, Dias S, et al. Long-term pituitary down-regulation before in vitro fertilization (IVF) for women with endometriosis. Cochrane Database Syst Rev 2006:CD004635

21. Bourdon M, Santulli P, Maignien C, et al. The deferred embryo transfer strategy improves cumulative pregnancy rates in endometriosis-related infertility: a retrospective matched cohort study. PLoS One 2018;13(4):e0194800

22. Santulli P, Bourdon M, Presse M, et al. Endometriosis-related infertility: assisted reproductive technology has no adverse impact on pain or quality-of-life scores. Fertil Steril 2016;105(4):978-87.e4

Do góry