Fertility Preservation in Women with Endometriosis: It is About Time We Talk About it!

Abstract

Endometriosis is a common benign disease that affects young women and carries a significant risk to the reproductive organs. Studies have shown that endometriosis is associated with diminished ovarian reserve and worse prognosis in assisted reproductive technology treatments. Surgical treatment aims to remove the disease while maintaining reproductive potential with minimal damage to the reproductive organs. The authors reviewed the published literature regarding fertility preservation in endometriosis, focussing on patient selection criteria, available treatment options, and follow-up. The goal of this study was to find evidence to answer the following clinical questions: how should women of reproductive age with endometriosis be managed, and what fertility-sparing options are available? Cryopreservation of embryos and mature oocytes are established techniques for preserving fertility in women during the reproductive period. Fertility preservation is a key consideration in the care of young girls and women with endometriosis, mainly those with ovarian endometriomas and advanced disease. Although no cohort studies have been published on the subject to date, adequate information detailing disease progression, treatment options, and the risks involved should be made available for these women. Available fertility preservation strategies include embryo and oocyte crypreservation, and women should be counselled individually on the risks, benefits, and costs involved with these options. In this scenario, management by a multidisciplinary endometriosis team is a fundamental step for producing successful results.