Treatment of Ovarian Endometriotic Cyst with Endometriosis-Associated Infertility in Women of Reproductive Age
This protocol targets a specific and clinically important scenario: a reproductive-age woman with an ovarian endometriotic cyst who has endometriosis-associated infertility and is pursuing spontaneous conception. The desire for natural pregnancy substantially changes both the treatment choice and the goals of care.
Infertility is one of the most significant complications of endometriosis, a condition primarily encountered in women of reproductive age. When a patient is actively pursuing natural conception, the treatment approach differs from that used in women who are not trying to conceive or who are considering assisted reproductive technology (ART).
Because standard medical therapies for endometriosis are contraceptive by mechanism, they are not appropriate for women pursuing spontaneous conception. The recommended approach is surgical, and the specific options differ in how they affect the remaining ovarian reserve. The complete protocol details the choice of technique and the considerations involved.
- Achievement of pregnancy
- Absence of cyst recurrence
DOI: 10.1007/s13669-011-0002-3
- Because endometriosis is primarily a disease encountered in women of reproductive age, infertility is one of its most important complications.
- The type of treatment may also be different for patients desiring natural conception and for those undergoing assisted reproductive technology (ART).
- Almost all medical treatments for endometriosis are based on the hormonal blockage of ovarian function and are thus contraceptive; therefore, medical treatment is usually not the chosen treatment for women pursuing spontaneous conception.
- Several reports, including randomized controlled trials, indicate that ovarian cystectomy by way of laparoscopy is superior to drainage or vaporization in terms of higher pregnancy rates and lower recurrence rates.
- Yazbeck et al. suggested that ethanol sclerotherapy may offer a better result because it causes less damage to the remaining ovarian function.