Abstract
Infertility is a main manifestation of endometriosis, though the exact pathogenesis of endometriosis-associated infertility remains unclear. Compromised ovarian functions may be one of the causes of endometriosis related infertility. The ovarian function can be classified into three basic elements, (1) production of ovarian hormones, (2) maintenance of follicular development until ovulation, and (3) reservoir of dormant oocytes (ovarian reserve). The effects of endometriosis on ovarian hormone production and follicular development are inconclusive. Ovarian endometrioma is common phonotype of endometriosis. Development of endometrioma per se may affect ovarian reserve. Surgery for endometriomas further diminish ovarian reserve, especially women with bilateral involvement. Early intervention with surgery and/or medical treatment may be beneficial, though firm evidence is lacking. When surgery is chosen in women at reproductive age, specific techniques that spare ovarian function should be considered.
Highlights
Endometriosis is a disease that affect 5–10% of women at reproductive age [1]
The ovarian function can be classified into three basic elements, (1) production of ovarian hormones, (2) maintenance of follicular development from preantral to postovulatory luteal stage, and (3) reservoir of dormant oocytes
Women who had operations for ovarian endometrioma showed reduced ovarian response with an increase in the total amount of gonadotropin, and a further decline in the mean number of retrieved oocytes, though neither clinical pregnancy rate nor live birth rate were not significantly affected [22]. These results may indicate that endometriomas per se may affect ovarian reserves, but not final therapeutic outcomes of assisted reproductive technologies (ART), which might be compensated for by controlled ovarian stimulation (COS)
Summary
Endometriosis is a disease that affect 5–10% of women at reproductive age [1]. the pain symptom is one of the main manifestations of this gynecologically commondisease, up to 50% of women with endometriosis suffer from infertility [2,3]. The causal relationship is not clearly determined, women with endometriosis may experience earlier menopause that those without disease [4]. These results may implicate that premature decline in ovarian function may be present in women with this disorder. The ovarian function can be classified into three basic elements, (1) production of ovarian hormones, (2) maintenance of follicular development from preantral to postovulatory luteal stage, and (3) reservoir of dormant oocytes. Endometriosis may affect these ovarian functions from several directions. The associations between ovarian functions and endometriosis are discussed along with current evidence
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