This article discussed current scientific data concerning the need and benefit of surgical treatment for endometriomas before in-vitro fertilization (IVF).
Endometriosis is a condition in which the tissue that lines the innermost layer of the uterus is found elsewhere in the body. Frequently, this tissue is found in the ovaries, where it may lead to the development of small cysts (fluid-filled pockets) called endometriomas.
Medication has a limited role in treating endometriomas. The first line of therapy remains surgery performed using laparoscopy (a minimally invasive surgery performed through small cuts with the help of a video camera). Endometriomas may themselves affect the normal functioning of the ovary. There is also evidence that endometriomas make IVF more difficult by complicating egg retrieval. Research has found that about 9% of endometriomas may harbor ovarian cancer. In younger patients, laparoscopy may restore fertility in 40-50% of cases. Outcomes are better if only one ovary is involved.
However, surgery has its risks, is costly and small amounts of normal ovarian tissue may be removed along with the endometrioma. This can lower ovarian reserve (ability of ovaries to produce eggs suitable for fertilization) which may impact future IVF success rates.
Published By :
Human Reproduction Update
Jan 26, 2006