Oocyte Cryopreservation in Patients with Endometriosis: Current Knowledge and Number Needed to Treat

Abstract

The rise of oocytes cryopreservation (OOC) in assisted reproductive techniques allows fertility preservation (FP) in an increasing number of indications. Endometriosis, a highly prevalent disease, potentially impairing ovarian reserve, seems, therefore, an interesting indication for it. The purpose of this study is to summarize the available evidence concerning FP by OOC in women with endometriosis and to calculate the number needed to treat (NNT). In total, 272 articles related to this topic were identified in PubMed. Eight studies were eligible for the review. In order to shed some light, a SWOT analysis was performed and the argument pros and cons were developed. The NNT calculated of OOC was 16, meaning that 16 women need to perform an OOC for one of them to have a child that she would not have had without this technique. In conclusion, OOC must be discussed with patients who suffer from endometriosis since it is an effective technique of FP, which can allow these patients to succeed a pregnancy that they otherwise would not have achieved. Nevertheless, it should not be performed in all patients as there is still a lack of robust socio-economic and risk–benefit data.

Clinical Utilities of Anti-Müllerian Hormone

“…According to Coccia et al, 20–50% of women who struggle with infertility also experience endometriosis [ 20 ]. While the underlying mechanism between the pathophysiology of the disease and infertility in endometriosis is not completely understood, it is suggested that ovarian reserve is impaired through chronic inflammation, increased oxidative stress, cell cycle dysregulation, and impaired angiogenesis [ 21 ]. A study conducted by Kitajima et al found that AMH levels in peritoneal fluid were lower in women with endometriosis compared to a control group of women without the disease [ 22 ].…”

“…Ovarian surgery specifically lowers AMH levels and AFC, causing a decline in fertility [ 24 ]. To combat this decline in fertility, oocyte cryopreservation has been offered as preoperative fertility preservation therapy in women with endometriosis [ 21 ].…”

“…Likewise, Cai et al found the average AMH serum levels in a sample of 125 patients to be 0.04 ± 0.10 ng/mL with POF and 0.69 ± 1.46 ng/mL with POI [ 30 ]. Additionally, Jiao et al found that in 601 patients with early POI or POF, the AMH was undetectable in 75.04% of them (451/601) [ 21 ].…”

Awareness and Knowledge of Libyan Women about Endometriosis

“…(Carrillo Torres et al, 2023), Many women with endometriosis experience delay between the onset of symptoms and initial diagnosis, which is mainly due to lack of awareness, which in turn affects progress of the disease and the prognosis of the condition. (Ramani Devi et al, 2021), Endometriosis surgery worsens the phenomenon induced by endometriosis itself as the disease is associated with infertility through various mechanisms, such as chronic inflammation, increased oxidative stress, impaired angiogenesis and cell cycle dysregulation (Henry et al, 2022). Evidence on women's fundamental knowledge of endometriosis and its consequences among college, medical and nursing students, is insufficient.…”

Comparison of Morphological and Digital-Assisted Analysis for BCL6 Endometrial Expression in Women with Endometriosis

“…Endometriosis, as well as its surgical management, can compromise the chances of pregnancy, particularly by altering the ovarian reserve. This is why an early diagnosis, which may allow oocyte vitrification to be carried out in order to preserve the patient’s chances of fertility, is essential in the management of these women [ 20 ]. In addition to the physical consequences, endometriosis induces a deleterious effect on the psychosocial and sexual wellbeing of women and imposes a substantial economic burden from a personal and societal point of view [ 21 , 22 ].…”