Effect of endometrioma and its surgical excision on fertility (Review)

Danni Jiang, Xiaocui Nie
Experimental and therapeutic medicine · 2020 · vol. 20(5) , pp. 1 · doi:10.3892/etm.2020.9242 · PMID:32989392 · W3087250927
review OA: diamond CC0 ⤵ 14 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This review indicates that prior endometrioma surgery may not improve assisted fertility outcomes and could decrease oocyte retrieval in women undergoing assisted reproductive technology.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This review examines whether ovarian endometrioma contributes to infertility and whether surgical excision improves fertility, focusing on evidence from spontaneous and assisted reproductive technology (ART) populations. It summarizes mechanistic hypotheses for impaired ovarian reserve, including potential structural/circulatory effects and oxidative/inflammatory changes within endometrioma fluid, and also compares clinical findings on anti-Mullerian hormone (AMH) and ART outcomes; it reports that prior surgery for endometrioma may not improve assisted fertility results and may reduce the number of oocytes retrieved. The review notes a limitation that an absolute cause–effect relationship between endometrioma and infertility requires further confirmation, and that evidence on ovarian reserve impacts is inconsistent across studies, such as reports linking AMH reduction more to surgery or to bilateral disease rather than to endometrioma alone. This paper is centrally about endometriosis — it specifically reviews how ovarian endometriomas and their surgical removal affect fertility and ovarian reserve, including outcomes relevant to endometriosis-associated infertility.

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Abstract

Endometrioma is the cystic lesion of ovaries originating from endometrial glands and stroma; it is identified in 17-44% of patients with endometriosis. Numerous existing studies have reported the association between endometrioma and infertility. However, an absolute cause-effect association requires further confirmation. Available evidence has suggested that ovarian reserve may be impaired by spatial occupation influences, local reaction or both, affecting the reproductive health of females. Given the increased focus on the pathophysiological mechanisms of endometrioma, surgical excision has commonly been considered to avoid further ovarian damage. However, the potential adverse effect of this surgery on the ovarian reserve has recently become a focal point. Whether or not surgical excision can facilitate subsequent conception in young females planning to be pregnant is controversial. As shown in the present review on the effects of endometrioma and its removal in females requiring assisted reproductive technology, prior surgery for endometrioma may not improve assisted fertility results and may further decrease the number of oocytes retrieved in the affected females. Subsequent studies are needed to ascertain the optimal management of infertility in the setting of endometriomas.

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Condition tags

endometriosisendometriomainfertility

Citation neighborhood (2-hop)

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. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (87)

Cited by (14)

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