The Significance of Planned Fertility Preservation for Women With Endometrioma Before an Expected Ovarian Cystectomy

Hong, Yeon Hee; Lee, Hyun Kyoung; Kim, Seul Ki; Lee, Jung Ryeol; Suh, Chang Suk

doi:10.3389/fendo.2021.794117

Cited by 12 publications

(16 citation statements)

References 45 publications

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“…Later updates by the same group in 2010 ( 370 ) and Donnez et al. in 2005 ( 371 ) reported a similar successful approach in endometriosis cases and to date, other few cases have been reported ( 372 – 378 ).…”

Section: Management Of Endometriosis Associated Infertilitymentioning

confidence: 88%

Endometriosis-associated infertility: From pathophysiology to tailored treatment

Bonavina

Taylor

2022

Front. Endocrinol.

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Despite the clinically recognized association between endometriosis and infertility, the mechanisms implicated in endometriosis-associated infertility are not fully understood. Endometriosis is a multifactorial and systemic disease that has pleiotropic direct and indirect effects on reproduction. A complex interaction between endometriosis subtype, pain, inflammation, altered pelvic anatomy, adhesions, disrupted ovarian reserve/function, and compromised endometrial receptivity as well as systemic effects of the disease define endometriosis-associated infertility. The population of infertile women with endometriosis is heterogeneous, and diverse patients’ phenotypes can be observed in the clinical setting, thus making difficult to establish a precise diagnosis and a single mechanism of endometriosis related infertility. Moreover, clinical management of infertility associated with endometriosis can be challenging due to this heterogeneity. Innovative non-invasive diagnostic tools are on the horizon that may allow us to target the specific dysfunctional alteration in the reproduction process. Currently the treatment should be individualized according to the clinical situation and to the suspected level of impairment. Here we review the etiology of endometriosis related infertility as well as current treatment options, including the roles of surgery and assisted reproductive technologies.

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Section: Management Of Endometriosis Associated Infertilitymentioning

confidence: 88%

Endometriosis-associated infertility: From pathophysiology to tailored treatment

Bonavina

Taylor

2022

Front. Endocrinol.

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“…A recent study by Hong et al. ( 10 ) reported that women with endometriosis had a significantly lower number of oocytes retrieved compared to infertile women without endometriosis, and therefore, the early timing of FP in women with such benign ovarian cysts is becoming of increased importance.…”

Section: Introductionmentioning

confidence: 99%

The Experience of Fertility Preservation in a Single Tertiary Center in Korea

et al. 2022

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ObjectiveOocyte (OC), embryo (EC), and ovarian tissue cryopreservation (OTC) are options for fertility preservation (FP) before going through gonadotoxic cancer treatment, or anticipated fertility decline in benign ovarian diseases, or for planned OC. The aim of this study is to report outcomes of FP in a single tertiary hospital in Korea.MethodsThis is a retrospective study of OC, EC, and OTC cycles. All patients who visited or were referred to the infertility clinic at the Department of Obstetrics and Gynecology for the purpose of FP between 2010 and October 2021 were included.ResultsA total of 564 controlled ovarian stimulation cycles were conducted in 416 women. Three hundred fifty-seven women underwent 494 OC cycles. Most patients were diagnosed with breast cancer (22.4%), followed by endometriomas (21.9%), and then by planned OC (20.7%). Cases of OC have increased over the years, peaking at 109 cycles in 2019 compared to one in 2010. Fifty-nine women underwent 70 EC cycles, and breast cancer (50.8%) was the most common indication. Repetitive OC and EC cycles were undergone in 92 and 9 women, respectively (mean number of repetition, 1.37 and 1.19 times in OC and EC, respectively), yielding a maximum number of 33 oocytes or 23 embryos being cryopreserved per patient. The utilization rate was 3.1% (11/357) in OC and 16.9% (10/59) in EC. Twenty-six women underwent OTC, and gynecologic cancer was the most common indication (9/26, 34.6%). One woman had the cryopreserved ovarian tissue retransplanted and successfully generated embryos.ConclusionOC, EC, and OTC are possible options for preserving fertility, and these opportunities should be provided for women at risk of fertility decline or those who are eager to protect their future fertility. This is the first report on long-term FP outcomes in a single tertiary center in Korea. We expect that there will be more cases over the years and more women returning to use their gametes or embryos for pregnancy.

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“…While previous studies have shown that COS outcomes could be worse if endometrioma is present, 3,44,45 there has been no previous study on the effect of dual triggering in patients with endometrioma. According to this study, dual trigger does not appear to be of great help in these patient groups.…”

Section: Discussionmentioning

confidence: 97%

Clinical efficacy of dual trigger with human chorionic gonadotropin and a gonadotropin‐releasing hormone agonist for women undergoing fertility preservation

Hong

Kim

Lee

et al. 2022

Reprod Medicine & Biology

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Purpose To determine the optimal maturation method to increase the yield of mature oocytes, especially for cancer patients with fewer chances of fertility preservation (FP) before gonadotoxic therapy. Methods A total of 373 cycles in 293 patients undergoing controlled ovarian stimulation (COS) for FP using a gonadotropin‐releasing hormone (GnRH) antagonist protocol were enrolled. The control group ( n = 225) received 250 µg of recombinant human chorionic gonadotropin (rhCG) while the study group ( n = 148) received 250 µg of rhCG and 0.2 mg of triptorelin for triggering. Subgroup analyses were performed for stimulation cycles with diminished ovarian reserve (DOR; anti‐Müllerian hormone (AMH) levels <1.1 ng/ml, n = 86), with endometrioma ( n = 104), or with breast cancer and endometrial cancer using 5 mg of letrozole during the COS cycles ( n = 84). Results There was no significant difference in the baseline characteristics or the number of total and mature oocytes between the two groups. Subgroup analyses for women with endometrioma or DOR showed similar results. However, the dual trigger group had a significantly higher number of mature oocytes than the rhCG trigger group in breast and endometrial cancer patients using letrozole during the COS cycles (6.9 ± 6.0 vs. 4.6 ± 3.6, p = 0.034). The maturation rate was higher in the dual trigger group, although the difference was not statistically significant (59.3 ± 26.7 vs. 50.0 ± 28.0, p = 0.124). Conclusions Dual triggering can be an efficient maturation method to maximize the yield of mature oocytes in breast or endometrial cancer patients using letrozole‐combined GnRH antagonist protocol for FP.

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The Significance of Planned Fertility Preservation for Women With Endometrioma Before an Expected Ovarian Cystectomy

Cited by 12 publications

References 45 publications

Endometriosis-associated infertility: From pathophysiology to tailored treatment

Endometriosis-associated infertility: From pathophysiology to tailored treatment

The Experience of Fertility Preservation in a Single Tertiary Center in Korea

Clinical efficacy of dual trigger with human chorionic gonadotropin and a gonadotropin‐releasing hormone agonist for women undergoing fertility preservation

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