Expectant, Medical, and Surgical Management of Ovarian Endometriomas

Ludovico Muzii, Giulia Galati, Giulia Mattei, Alessandra Chinè, Giorgia Perniola, Violante Di Donato, Chiara Di Tucci, Innocenza Palaia
Journal of clinical medicine · 2023 · vol. 12(5) , pp. 1858 · doi:10.3390/jcm12051858 · PMID:36902645 · W4322503508
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This review evaluates conservative management and surgical techniques for ovarian endometriomas, focusing on their impact on ovarian reserve.

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Abstract

Management options for ovarian endometriomas include expectant management, medical treatment, surgical treatment, in vitro fertilization (IVF), or a combination of the above. The choice of management depends on many clinical parameters that should be taken into consideration, the first of which is the main presenting symptom. Most patients are today referred to medical therapy as a first option in the case of associated pain, and to IVF in the case of associated infertility. When both symptoms are present, usually surgery is the preferred approach. Recently, however, surgical excision of an ovarian endometrioma has been associated with a postoperative reduction in the ovarian reserve, and recent guidelines suggest that the clinician should caution the patient as to the possible damage to the ovarian reserve in the case of surgery. However, evidence has been published as to a possible detrimental effect of the ovarian endometrioma on the ovarian reserve even if expectant management is followed. In this review, the current evidence on the conservative management of ovarian endometriomas, with particular focus on the issue of the ovarian reserve, is evaluated, and the different surgical techniques for the treatment of ovarian endometriomas are discussed.

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Condition tags

endometriomainfertility

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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