Relationship between ovarian cysts and infertility: what surgery and when?

Legendre, Guillaume; Catala, L.; Morinière, Catherine; Lacoeuille, C. Lefebvre; Boussion, F.; Sentilhes, Loïc; Descamps, Philippe

doi:10.1016/j.fertnstert.2014.01.021

Cited by 51 publications

(39 citation statements)

References 80 publications

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“…1 Regardless of the location of the disease, the estimated prevalence of endometriosis has been concerningly described to be up to 11% in the general female population, 2 but it dramatically increases among infertile women. 3 Although it has been clearly demonstrated that endometriosis reduces fertility, [4][5][6][7] pregnancy among women affected by this disease is becoming increasingly common, thanks to assisted reproductive technology (ART) 8 and complex surgical eradicative procedures. [9][10][11][12][13][14][15][16][17] Despite the rising rates of pregnant women with a previous diagnosis of endometriosis (and in many cases also previous surgical procedures for this condition), information regarding the possible effect of the disease on obstetrical and neonatal outcomes is still scant.…”

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confidence: 99%

Pregnancy after Endometriosis: Maternal and Neonatal Outcomes according to the Location of the Disease

et al. 2019

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Objective To systematically evaluate pregnancy and labor course, obstetrical complications, and maternal and neonatal outcomes in women with endometriosis, stratifying according to the specific location of the disease. Study Design We retrospectively analyzed our prospectively maintained obstetrical database from January 2011 to August 2014 to identify all women with a previous histological diagnosis of endometriosis who delivered at our institution (cases). We divided the cases according to the specific location of the disease (deep infiltrating endometriosis, ovarian endometriosis, and peritoneal endometriosis). As controls, we identified all unaffected women who delivered in the year 2013. To avoid the confounding effect of parity, we limited our analysis to nulliparous women. Results A total of 118 nulliparous women with endometriosis and 1,690 nulliparous controls were identified. Women with endometriosis were significantly older, had a lower body mass index, and had a higher incidence of assisted reproductive technology. The duration of pregnancy was significantly shorter among women with endometriosis. A higher incidence of placenta previa (3.4 vs. 0.5%; p = 0.006), hypertension (11 vs. 5.9%; p = 0.04), cesarean section (41.5 vs. 24.2%; p < 0.0001), and vacuum delivery (10.1 vs. 2.9%; p = 0.006) was found in women with endometriosis. Neonatal outcomes were similar between groups. The incidence of placenta previa in patients with deep endometriosis was 11.7 versus 0.5% among controls (p < 0.0001), whereas in women with ovarian and peritoneal endometriosis, it was similar to the controls. Conclusion Women with endometriosis have a higher incidence of vacuum delivery, cesarean section, and placenta previa compared with unaffected women. The higher risk of placenta previa is attributable exclusively to women with deep endometriosis. Neonatal outcomes are unaffected by the presence of the disease.

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confidence: 99%

Pregnancy after Endometriosis: Maternal and Neonatal Outcomes according to the Location of the Disease

et al. 2019

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“…13 cm, suggesting that sugery on cysts with larger diameters could result in exposure of extensive vessels. Furthermore, controversies regarding the best surgical intervention to manage mature teratomas exist given that these cysts are extremely common among reproductive-aged women and they also grow very slowly, i.e., by 1.7-1.8 mm each year [25]. Kim et al reported no difference in preoperative serum AMH level between women with mature teratoma and age-and BMImatched controls [26].…”

Section: Discussionmentioning

confidence: 99%

“…Kim et al reported no difference in preoperative serum AMH level between women with mature teratoma and age-and BMImatched controls [26]. Legendre et al recommended that a wait-and-see attitude appears reasonable for asymptomatic women, especially for moderate-sized mature teratomas (4-6 cm), where the risk of secondary interventions is low [25]. However, our results showed that laparoscopic cystectomy is associated with severe damage to the ovarian reserve, particularly with cysts > 5.13 cm.…”

Section: Discussionmentioning

confidence: 99%

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Influence of Cyst Size on Ovarian Reserve After Unilateral Laparoscopic Ovarian Cystectomy for Endometrioma and Ovarian Mature Teratoma.

Chae¹

2020

Preprint

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Abstract Background:The present study is aimed to investigate the influence of ovarian cyst size on serum anti-Müllerian hormone levels after laparoscopic ovarian cystectomy in women with endometrioma and ovarian mature teratomaMethods: From March 2017 to December 2018, we retrospectively studied eighty-one patients who underwent unilateral laparoscopic cystectomy for endometrioma (n = 41, endometrioma group) and ovarian mature cystic teratoma (n = 40, teratoma group). Serum anti-Müllerian hormone (AMH) levels were measured preoperatively and 1 month after surgery.Results: The rate of decrease in serum AMH levels after laparoscopic cystectomy was significantly higher in the endometrioma group than in the teratoma group (0.35 ± 0.04% vs. 0.19 ± 0.04%, p = 0.013). In patients with mature cystic teratoma, a statistically significant correlation between the rate of decrease in serum AMH levels and cyst size was observed (r = 0.391, p = 0.013); the rate of decrease in serum AMH levels after surgery was significantly higher in the > 5.13 cm subgroup than in the ≤ 5.13 cm subgroup (p = 0.006). Conclusions: Laparoscopic cystectomy for endometriomas may result in a more significant damage to the ovarian reserve compared with that for ovarian mature cystic teratomas. Cyst diameter and reduced ovarian reserve after surgery were not correlated in patients with endometriomas, whereas a significant correlation was observed in patients with ovarian mature teratomas. The decrease in AMH levels was more evident in patients with a mature teratoma > 5.13 cm.

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“…They tend to have diiculty conceiving owing to ovulatory dysfunction as well as poor oocyte quality and endometrial receptivity [23]. However, the results of epidemiologic data obtained mainly from comparative studies and cohorts, have concluded that the role and size (<6 cm) of ovary cysts in infertility is controversial [24].…”

Section: Ovulatory Disordersmentioning

confidence: 99%

Complementary and Alternative Therapy with Traditional Chinese Medicine for Infertility

Liao¹,

Hu²,

Hung³

2017

Chinese Medical Therapies for Diabetes, Infertility, Silicosis and the Theoretical Basis

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Infertility results in a country with a low birth rate and an aging population, and thus there is vested interest in treating this problem by using both complementary and alternative therapies, in addition to conventional western medicine. Traditional Chinese medicine (TCM) has been widely used for healthcare in the Eastern world for thousands of years. This chapter describes the evidence to support the role of TCM in the management of male and female infertility.

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Relationship between ovarian cysts and infertility: what surgery and when?

Cited by 51 publications

References 80 publications

Pregnancy after Endometriosis: Maternal and Neonatal Outcomes according to the Location of the Disease

Pregnancy after Endometriosis: Maternal and Neonatal Outcomes according to the Location of the Disease

Influence of Cyst Size on Ovarian Reserve After Unilateral Laparoscopic Ovarian Cystectomy for Endometrioma and Ovarian Mature Teratoma.

Complementary and Alternative Therapy with Traditional Chinese Medicine for Infertility

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