Endometrioma,surgery,and,possibilities,of,early,disease,control
Vasilios Tanos, Elsie Sowah
1University of Nicosia Medical School, Nicosia 2408, Cyprus.
2Department of Obstetrics and Gynaecology, Aretaieo Hospital, Strovolos, Nicosia 2024, Cyprus.
3St. George’s, University of London, London, SW17 ORE United Kingdom
Abstract Aim: The purpose of this study is to investigate the efficacy of surgical management in ovarian endometrioma for early disease control and long-term fertility preservation in adolescents and women of very young age. A history of cyclic pains in adolescents is highly associated with endometriosis. Sonography enables the diagnosis of small endometriomas 1-2 cm in diameter. Although it is obvious that the risk of damage to normal ovarian tissue is diminished when operating and removing a 2 cm endometrioma, it is not approved since there are currently no tools available to identify at-risk patients. Additionally, performing laparoscopic surgery with 5 mm instruments in patients with small endometriomas will likely cause more harm than benefit.
Methods: A literature review was performed using key words for endometrioma surgery, in vitro fertilization(IVF), implantation rate, pregnancy rate and adolescents. The pros and cons of surgical removal prior to assisted reproductive therapy (ART), outcomes of endometrioma surgical treatment before IVF, and current recommendations for endometrioma removal were investigated.
Results: The total patient population from articles supporting removal of endometrioma before assisted reproductive therapy and evidence against were 30,741 and 9983 respectively. However, the only study reporting a statistically significant result found an 8.2% implantation rate for the surgical removal group vs. 12...
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