A narrative review of endometriosis surgery and infertility

Abstract

: Ectopic implantation of endometrial tissues outside of the endometrial layer is termed as endometriosis, which affects almost 10% of childbearing women, and the onset of pathogenesis goes back to the first menstrual bleeding. The frequency is increased to 25–50% in women diagnosed with infertility. The existence of endometriosis negatively effects fertility by many different pathways, but its surgical treatment may also decrease the potential for fertility. The goal of endometrioma surgery is to remove the cyst without tissue remnants and preserve the ovarian reserve as much as possible. In case of endometriosis if surgical intervention is a must for women with endometriosis, oocyte collection and embryo freezing before surgical intervention is recommended. Surgical intervention after fertility preservation in endometriosis minimizes the stress of the patient and surgeons feel safer during the surgical intervention. In patients with endometriosis, the choice of expectant management or surgical intervention should be individualized. In cases where the chance of spontaneous conception is high, surgery remains the primary option for appropriate treatment. Laparoscopic surgery is the preferred method for surgical removal of endometriotic lesions and surgery should be performed by skilled and specially trained surgeons. Deciding about the modality of endometriosis treatment is a controversial issue and preservation of fertility in women with endometriosis is fundamental. Each patient must be evaluated individually according to their symptoms, severity, age, expectations, and risks. 6