Fertility Desires Research Articles

Progress in High Intensity Focused Ultrasound Ablation for Fertility Preservation Therapy of Uterine Fibroids and Adenomyosis.

High intensity focused ultrasound (HIFU) is an effective and safe non-invasive treatment method, widely used in the treatment of uterine fibroids and adenomyosis in the field of gynecology. The side effects in HIFU is low in incidence and mild. HIFU can significantly alleviate the symptoms of patients, reduce lesion volumes, improve quality of life, and has good cost-effectiveness. HIFU can accurately ablate the uterine fibroids and adenomyosis lesions, without destroying normal myometrium and endometrium, and thus HIFU is a promising alternative to myomectomy in uterine fibroids patients with fertility desire. Several studies have shown that in terms of ovarian endocrine function protection, HIFU treatment is superior to uterine artery embolization, and similar to myomectomy. Existing limited researches show that patients with uterine fibroids have a favorable pregnancy rate and live birth rate, as well as a lower natural abortion rate after HIFU treatment. Pregnancy rate after HIFU treatment for uterine fibroids is not lower than myomectomy, and higher than uterine artery embolization. HIFU may have significant advantages in shortening pregnancy interval compared with myomectomy. However, the proportion of cesarean section delivery after HIFU treatment is relatively high, and gestational uterine rupture after HIFU treatment exist in literature. Higher quality clinical data is needed to confirm the pregnancy outcomes and safety after HIFU treatment in future.

The fertility gap and economic freedom

AbstractThe difference between desired fertility and achieved fertility is called the fertility gap. This paper investigates the relationship between economic freedom and the fertility gap across the United States since greater economic freedom may empower individuals to choose work more compatible with their family goals. We test this hypothesis using individual measures of fertility preferences from a nationally representative survey of reproductive‐aged women (2020–2024) and find evidence that women are more likely to achieve their family goals in states with greater economic freedom. This effect is strongest when focusing on variation in labor market freedom.

Predictors of Fertility Desire During COVID-19 Pandemic: A Cross Sectional Study

Background: Fertility, the most important factor in population growth, is affected by various factors, including pandemics. COVID-19 (CV) was a global challenge that spread rapidly around the world. Objective: This study aimed to investigate predictors of fertility desire during the covid virus pandemic. Methods: In this cross-sectional study, 315 women who visited health centers in northern Iran for vaccination against covid virus were recruited using convenient sampling. The participants completed the sociodemographic information, Fertility Desire Scale, and Fear of covid virus scale. Logistic regression analysis was employed to assess the predictive factors of fertility desire. Results: The participants' mean age and marriage duration were 34.4 ± 6.7, and 7.3±11.5 years, respectively. It showed fertility desire among household women was about twofold more compared to employed ones [Odds Ratio (OR) = 1.96, p = 0.009)]. The fertility desire was decreased among more educated women (OR = 0.43, p= 0.035), women with one child (OR = 0.44, p= 0.030), and women with no infant gender preferences (OR = 0.53, p= 0.032). Fear of covid virus and any history of covid virus infection in the participants or their close relatives did not change fertility desire (P > 0.05). Conclusion: In conclusion, health policymakers should pay more attention to the potential effects of women's employment, their educational status, and their attitude toward infant gender preferences on fertility desire during the development of programs. Further research is needed to examine this empirical association on a global scale and its effect on trying to conceive.

Infertility in the Capital Region of Denmark: Prevalence and population characteristics

Abstract Background Infertility is a disease defined by failure to achieve a pregnancy within 12 months of trying. Infertility has-until now-not been monitored in Denmark for three decades. The aim of this study was to assess the prevalence of infertility in persons aged 25-44 years in the Capital Region of Denmark, and to describe characteristics of persons with infertility. Methods Life-long experience of infertility was assessed in the Danish Capital Region Health Survey 2021, including 56,245 participants from the general population aged ≥16 years (response rate 54.9%). In this study, only persons aged 25-44 years who had tried to have children (thus knowing their fertility) were included, resulting in 8,203 participants. Characteristics of persons with infertility were assessed using national registries (socio-demographics) and questionnaire data (health status). Descriptive analyses and multivariate logistic regression models weighted for survey design and non-response were performed. Results Among persons aged 25-44 years, who had tried to have children, 20% had experienced infertility. Among those, 44% did not achieve the children they wanted. Infertility was most common among women (22%) and persons aged 35-44 years (21%). No associations were observed between infertility and ethnicity, education, and employment status. Persons with infertility were more likely to have poor physical health, have higher level of stress symptoms and have obesity compared with persons in same age group, who had tried to have children but not experienced infertility. Conclusions Infertility is very common in the general population and is associated with unmet fertility desires as well as poor physical health and high stress level. These findings highlight the importance of focusing on and prioritizing treatment and prevention of infertility and emphasize the need for further research in and continued monitoring of infertility. Key messages • Infertility is very common in the general population and associated with unmet fertility desires and poor health highlighting the importance of prioritizing treatment and prevention of infertility. • Continuous monitoring of infertility in the general population is essential as well as further research into risk factors and consequences of infertility.

Predictors and number of antenatal care visits among reproductive age women in Sub-Saharan Africa further analysis of recent demographic and health survey from 2017-2023: Zero-inflated negative binomial regression.

Antenatal care (ANC) is an important component of maternal and child health care. To reduce perinatal mortality and improve women's experience of care, the World Health Organization (WHO) recommends pregnant women should attend at least eight ANC visits. However, in Sub-Saharan Africa (SSA), the mean number of ANC visits among reproductive-age women using Demographic and Health Surveys (DHS) data following the new WHO recommendation is so far limited. Therefore, the study aimed to determine the mean number of ANC visits and its predictors among reproductive-age women in SSA. Community-based cross-sectional study was conducted among 188,880 weighted reproductive-age women in SSA using a recent round of DHS data from 2017-2023. Zero-inflated negative binomial regression (ZINB) was conducted and statistical significance was declared at p-value <0.05 and adjusted incidence rate ratio(AIRR) for count model part and adjusted odds ratio for logit model inflated part of ZINBR with 95% confidence interval (CI) were reported. The mean number of ANC visits among reproductive-age women in SSA was 4.08 with 95%CI [4.07, 4.09]. Among reproductive-age women who gave birth in the last five years before the survey, 7.3% had eight or more ANC visits during pregnancy. Age of women, maternal and husband educational status, types of pregnancy, birth order, household size, number of under-five children, and wealth index were associated with the numbers of ANC visits among reproductive-age women in Sub-Saharan. The mean number of ANC visits among reproductive-age women in SSA is too lower than the new WHO recommendation of ANC visits for a positive pregnancy experience. This study also highlights that the proportion of at least eight ANC visits is low and there are still disparities in the mean of ANC visits across different regions of SSA. The increasing maternal age, higher maternal and husband educational status, wanted pregnancy, the number of household members, the number of under-five children, and higher wealth index increase the number of ANC visits. Unwanted pregnancy, no more fertility desire, and rural residences were contributed for zero ANC visits in SSA. Therefore, efforts should be geared towards improving maternal and husband's educational status. We strongly recommend that the governments of SSA countries should empower women economically and educationally to achieve the goals of ANC as recommended by the WHO.

The prevalence and etiology of infertility in a tertiary specialist hospital in the Gambia

Background: Infertility is a public health problem that has received little or no attention in most sub-Saharan Africa, especially in the Gambia. The prevalence of infertility in the Gambia is increasing from 9.0% in 1998 to 14.3% in 2017. Tubal factor was the predominant leading cause for decades, but recent reviews suggest that male factor is driving the epidermic of infertility worldwide. Therefore, the aim of this study was to determine the prevalence and etiological factors of infertility in our practice. Methodology: The design was a retrospective quantitative study. Data collection tool was developed and variables were retrieved from case notes between August 2022 to March 2023 at a specialist hospital in the Gambia. The data were entered into a computer database and analyzed using descriptive statistics. Results: Total number of women in the reproductive age of 15–49 years that attended gynecology clinic was 1475. Two hundred eighty-five couples (285) had infertility. The prevalence of infertility is 19.3% ~1:5 couples. The causes showed male factor 69 (45.4%), ovulation disorder 34 (22.4%), tubal factor 20 (13.2%), uterine factor 8 (5.3%), and unexplained 21(13.8%). Ovarian factors showed age-related poor ovarian reserve. Overall, male factor infertility was 53%, and female factor infertility was 47%. Conclusions: The prevalence of infertility is increasing and male factor is 3-folds and 2-folds higher than tubal and ovarian factors, respectively. The study observed increasing desire of fertility among female in advanced age. Universal access to assisted reproductive technology is essential.

Perspectives of Young Men With Spina Bifida on Fertility Potential and Future Parenthood

ObjectivesTo explore the perspectives of young adult males with spina bifida on their fertility potential and parenthood. MethodsSemi-structured qualitative interviews were conducted between 2/2021-5/2021 with men ≥18 years of age with spina bifida on perspectives on fertility potential and parenthood. Demographic and clinical characteristics were obtained from a survey and chart review. Interviews were transcribed verbatim and assessed through conventional content analysis framework. ResultsOf 30 eligible individuals approached, 20 agreed to participate. Median age was 22.5 years (range 18-29), and 80% had myelomeningocele. Most reported not being in a relationship (14/20, 70%), not being currently sexually active (13/20, 65%), and no participant reported a history of paternity. Many reported a desire for future fertility. Uncertainty and areas of concern were identified regarding their physiologic and psychosocial ability to be a parent. Perceived barriers to achieving parenthood included: 1) uncertainty around fertility potential and the hereditary nature of SB; and 2) concerns with being a parent and raising a child. Facilitators to help overcome uncertainty, such as gaining knowledge on fertility testing options and understanding means of preventing neural tube defects, were identified. Participants expressed the importance of strong peer and family support to help overcome challenges related to parenthood. ConclusionsMen with spina bifida are interested in future fertility, yet uncertainty exists around the physiologic and psychosocial ability to be a parent. Facilitators to help overcome uncertainty and concerns should be a focus of patient counseling around future fertility with young men with spina bifida.

Fertility intentions of China’s one-child generation: a comparative analysis with the US

ABSTRACT In 1979, China introduced the one-child policy to curb rapid population growth, enforcing birth quotas with penalties. This study examines the impact of only-child status on fertility intentions using data from the 2017 Chinese General Social Survey. Findings from OLS and multinomial logistic regression models indicate that only children have significantly lower fertility desires, even after controlling for demographic and socioeconomic factors. Notably, only children have a 20% higher likelihood of wanting 0–1 children compared to those with siblings. An OLS model interacting only-child status with birth cohort reveals that individuals born during the peak enforcement period (1979–1983) exhibit particularly reduced fertility intentions, reflecting a stronger internalization of small family ideals. Although this effect weakens in later cohorts, the association between only-child status and lower fertility desires persists. A comparative analysis with data from the 2016 and 2018 US General Social Survey shows that these patterns are unique to China, underscoring the lasting influence of the one-child policy on fertility mindsets. The results suggest that China's continued low fertility may be partly driven by these deeply ingrained attitudes.

Does fiscal expenditure help to improve the fertility desire of rural families? An empirical study based on the CFPS database

This paper empirically examines the impact of the level of fiscal expenditure in the micro-family's region on the fertility desire of rural families in China. The empirical results of this paper indicate that fiscal expenditure can significantly enhance the fertility desire of rural families. After a series of robustness tests, the baseline regression results still hold. Further heterogeneity analysis indicates that the positive promotion effect of fiscal expenditure on the fertility desire of rural families is more pronounced for families in areas with lower degrees of marketization and for samples with lower family income levels.

Fertility Desire of Women and Related Factors: Karabuk and N Djamena Samples

Fertility Desire of Women and Related Factors: Karabuk and N Djamena Samples

Marriage and Fertility Desire and Associated Factors Among Unmarried People Living With HIV in Jinan, China: A Cross-Sectional Study.

The desires for marriage and fertility among people living with HIV (PLWH) are increasing worldwide because of improved treatment and prognosis; yet they remain understudied in China, which has a family-oriented culture. This study aimed to investigate these desires for marriage and fertility among Chinese PLWH and explore their correlates. A cross-sectional study was conducted among 1,504 Chinese PLWH to assess their desires for marriage, fertility, and other variables through an online questionnaire. Logistic regression models were used to analyze factors associated with desires for marriage and fertility. Among the 1,504 participants, 53.9% aspired to marry at 34.76 ± 5.26 years old, whereas 62.0% desired parenthood at 36.43 ± 5.11 years old. Factors associated with these desires included age, gender, residence, education level, HIV transmission route, CD4 + T-cell count, time since HIV diagnosis, disclosure of HIV status, social support, and mental health indicators.

Window of Opportunity: Rate of Referral to Infertility Providers among Reproductive-Age Women with Newly Diagnosed Gynecologic Cancers.

Background/Objective: Fertility preservation is an important part of oncologic care for newly diagnosed gynecologic cancers for reproductive-age women, as many treatment options negatively impact fertility. The goal of this study is to examine factors that influence access to fertility specialists for women with newly diagnosed gynecologic cancer. Methods: This institutional review board approved a retrospective cohort study investigating the impacting factors on the referral rate from gynecologic oncologists (GO) to reproductive endocrinologists and infertility (REI) specialists at a single academic institution between 2010-2022 for patients age 18-41 at diagnosis. Electronic medical records were used to identify demographics and referral patterns. Mixed logistic models were utilized to control cluster effects of the physicians. Results: Of 816 patients reviewed, 410 met the criteria for inclusion. The referral rate for newly diagnosed gynecologic malignancies was 14.6%. Younger patients were more likely to have an REI referral (p < 0.001). The median time from first GO visit to treatment was 18.5 days, and there was no significant difference in those who had REI referrals (p = 0.44). Only 45.6% of patients had fertility desire documented. A total of 42.7% had fertility-sparing treatment offered by a GO. REI referral did not significantly change the time to treatment (p = 0.44). An REI referral was more likely to be placed if that patient had no living children, no past medical history, or if the referring GO was female (OR = 11.46, 6.69, and 3.8, respectively). Conclusions: Fertility preservation counseling is a critical part of comprehensive cancer care; yet, the referral to fertility services remains underutilized in patients with newly diagnosed gynecologic cancer. By demonstrating these biases in REI referral patterns, we can optimize provider education to enhance fertility care coordination.

Risk Factors and Prediction Nomogram of Local Regeneration After Ultrasound-Guided Microwave Ablation of Uterine Fibroids

To explore the risk factors associated with uterine fibroids (UFs) local regeneration of the treated UFs after microwave ablation (MWA) and to develop a nomogram model for predicting the risk of local regeneration. Retrospective study. The Eighth Affiliated Hospital of Sun Yat-sen University. Patients with UFs who underwent MWA at our hospital between October 2020 and April 2023 were included. MWA was used for the treatment of UFs. A total of 47 patients with 68 fibroids were included into this study. Over a median follow-up of 13 months (interquartile range: 8 to 22 months), local regeneration occurred in 11 UFs. The clinical and imaging characteristics of these patients were recorded and compared. Risk factors for local regeneration were determined through univariate and multivariate Cox regression analysis. Multivariate analysis revealed that the fertility desires, larger size of UFs (≥95.3cm3) and hyper-enhancement of UFs on contrast-enhanced ultrasound (CEUS) were independent risk factors for local regeneration after MWA. A predictive nomogram was constructed to predict the local regeneration after MWA of UFs. The concordance index (C-index = 0.924, internal validation C-index = 0.895) and the 1-year and 2-year area under the curve (AUC) values (0.962, 0.927) all indicated that the nomogram had good predictive performance. Calibration and decision curve analysis (DCA) curves further confirmed the model's accuracy and clinical utility. Fertility desires, larger size of UFs and hyper-enhancement on CEUS were independent predictors of UFs local regeneration after MWA in our study. The nomogram constructed based on the above independent risk factors may help predict which UFs will develop local regeneration after MWA.

A Cross-Sectional Survey of Healthcare Professionals' Knowledge, Attitude and Current Behaviours towards Female Fertility Preservation Services within the UK.

(1) Background: This study aims to establish the knowledge, attitudes and current behaviours towards female fertility preservation (FP) services amongst healthcare professionals (HCPs) in the UK. (2) Methods: An online survey was advertised publicly on the social media platform Instagram between 25 February 2021 and 11 March 2021. (3) Results: In total, 415 participants fulfilled the inclusion criteria and completed the survey. The majority of HCPs discussed FP techniques either never 39.5% (n = 164), once a year 20.7% (n = 86) or once a month 17.8% (n = 74). The majority rated their knowledge of each type of FP method as 'very poor' or 'poor' and strongly disagreed 14.2% (n = 59) or disagreed 42.2% (n = 175) with the statement they 'felt confident to counsel a patient on FP'. The majority either agreed 37.8% (n = 157) or strongly agreed 22.2% (n = 92) that it was their responsibility to discuss FP and 38.1% (n = 158) agreed or strongly agreed 19.5% (n = 81) they considered the desire for future fertility when planning treatment. The majority 87.2% (n = 362) had not experienced formal training on FP. (4) Conclusions: Discrepancies in knowledge remain regarding techniques of FP, referral pathways, awareness of facilities offering services and existing educational resources. Many HCPs recognise the importance of FP and their responsibility to initiate discussions. The knowledge that FP may not delay the treatment of cancer has also improved; however, training in FP is scarce.

Assessing Trends in the Desire to Avoid Pregnancy: A Cautionary Note.

The desire to avoid pregnancy-to delay the next birth or have no further births-is a fundamental sexual and reproductive health indicator. We show that two readily available measures-prospective fertility preferences and the demand for contraception [Demand] construct-provide substantially different portraits of historical trends. They also yield correspondingly different assessments of the sources of contraceptive change. We argue, with supporting empirical evidence, that Demand enormously overstates the historical trend in the desire to avoid pregnancy because Demand as currently constructed is in part a function of contraceptive prevalence. This makes for "reverse causality" in decompositions of contraceptive change, producing an upward distortion on the order of 25 percentage points in the amount of contraceptive change attributed to a change in fertility desires. Decomposition of contraception change free of the distortion reveals that contraceptive change has been due almost entirely to more complete implementation of fertility preferences. This is explained in part by the surprisingly slight historical change in preferences, a fact we document and then show is a consequence of a historical shift in parity composition toward lower parities.

Barriers and facilitators of early postpartum modern contraceptive method uptake in Dessie and Kombolcha City zones, northeast Ethiopia: Conventional content analysis qualitative study.

Despite progress in access to family planning services in many sub-Saharan African countries in recent decades, advances in effective early postpartum contraceptive adoption remain low, and the unmet need for early postpartum contraceptives is high. In Ethiopia, early postpartum modern contraceptive method uptake is still unacceptably low. The barriers/challenges have not yet been sufficiently explored. A deep and detailed understanding of the contextualized barriers and challenges in the adoption of early postpartum contraceptive methods is crucial in developing future locally-appropriate interventions. This study aimed to explore barriers/challenges to the uptake of early postpartum modern contraceptive methods after childbirth in Dessie and Kombolcha zones, in northeast Ethiopia. Aconventional content analysis qualitative study was deployed in Dessie and Kombolcha town zones, northeast Ethiopia using a theoretical purposive sampling technique. A total of 57 study subjects were participated. The sample size was determined using the rule of information saturation through 7 key informant interviews, 6 in-depth interviews, and 5 focused-group discussions with 8-10 participants each. Data were collected using an unstructured interview guide and recorded using a digital audio recorder and field notes. The trustworthiness of the study was assured using different techniques. The collected data were transcribed and translated from native language to English. Atlas-ti version7 software was used to facilitate conventional content qualitative data analysis approach. Open coding, categories, subthemes, and overreaching themes were developed, and a conceptual model of barriers was organized through network analysis. Barriers to uptake of early postpartum modern contraception quoted by study participants and themed were related knowledge, attitude, family-community, health facility, contraceptive method, cultural, religious, fertility desire, gender issues, and misconceptions. The sub-themes of knowledge-related barriers that emerged were lack of awareness of the time to take birth control methods, not knowing the time pregnancy is likely after childbirth, and not being committed to taking contraceptives early enough after childbirth. Moreover, beliefs that modern contraceptives cause breast milk to dry up and perceived low fecundability after childbirth were indicated as attitude barriers. Health facility barriers were lack of reminders and follow-up mechanisms, sporadic service delivery and opening time, long waiting time, and card withdrawal process and providers' approach. Social stigma, child sex preference, and religious restrictions against contraceptive use were community barriers. Generally individual, facility-based, method-related, misconceptions, societal, and cultural barriers were identified as hindrances to the uptake of early postpartum modern contraceptive methods. There is a need for health-seeking behavioral interventions, innovative contraceptive methods, and facility-level interventions to overcome each identified barrier.

Climate change and fertility desires: An experimental study among university students in Belgium and Italy

Climate change and fertility desires: An experimental study among university students in Belgium and Italy

The abortion trend after the pronatalist turn of population policies in Iran: a systematic review from 2005 to 2022

ObjectiveGiven Iran’s recent shift towards pronatalist population policies, concerns have arisen regarding the potential increase in abortion rates. This review study examines the trends of (medical), intentional (illegal), and spontaneous abortions in Iran over the past two decades, as well as the factors that have contributed to these trends.MethodsThis paper reviewed research articles published between 2005 and 2022 on abortion in Iran. The study employed the PRISMA checklist for systematic reviews. Articles were searched from international (Google Scholar, PubMed, Science Direct, and Web of Science) and national databases (Magiran, Medlib, SID). Once the eligibility criteria were applied, 42 records were included from the initial 349 records.ResultsAbortion is influenced by a variety of socioeconomic and cultural factors and the availability of family planning services. Factors that contribute to unintended pregnancy include attitudes toward abortion, knowledge about reproductive health, access to reproductive health services, and fertility desires, among others. In addition to health and medical factors, consanguineous marriage plays an important role in spontaneous and therapeutic abortion. A higher number of illegal abortions were reported by women from more privileged socioeconomic classes. In comparison, a higher number of medical and spontaneous abortions were reported by women from less privileged socioeconomic classes.ConclusionIranian policymakers are concerned about the declining fertility rate and have turned to pronatalist policies. From a demographic standpoint, this seems to be a reasonable approach. However, the new population policies, particularly, the Family Protection and Young Population Law, along with creating limitations in access to reproductive health services and prenatal screening tests as well as stricter abortion law could potentially lead to an increase in various types of abortions and their associated consequences.

Correlates of fertility desires in women with urogenital fistula in the Democratic Republic of Congo: a cross-sectional study of 1,646 women

BackgroundStudies on fertility desires among fistula patients in the Democratic Republic of Congo (DRC) have been conducted on fewer patients. Furthermore, these studies have adopted a univariate descriptive approach. This study aims to examine the determinants of fertility desires among patients with fistula in the DRC.MethodsThis cross-sectional study included women aged 15–49 whose fistulas were repaired by the Panzi Hospital mobile team in seven DRC regions between 2013 and 2018. Univariate and bivariate descriptive analyses were performed using the frequency distribution table and the chi-square test. Adjusted odds ratios with their 95 confidence intervals from logistic regression were used to analyze factors associated with fertility desire after fistula repair. All analyses were stratified by parity level for all women aged 15–49 and 20–34 years.ResultsOf the 1,646 women aged 15–49 and 808 aged 20–34, 948 (57.6%) and 597 (73.8%), respectively, wanted to have children after fistula repair. Among women aged 15–49 and 20–34 years, the desire to have children was parity-specific. It was negatively associated with age at all parity levels. In women with low parity, the desire for children was significantly negatively associated with a high number of surgeries, abortions, and fistula duration. It tended to decrease with time, but was particularly high in 2014 and 2017. It was high among the Protestant women. Among medium-parity women, it was significantly lower in urban areas and among widows, but higher among women who had more than two abortions. Among high-parity women, it was negatively associated with education level.ConclusionTo help women with fistula achieve or approach their desired number of children, our findings suggest that (1) counseling is needed for women with a high desire for children; (2) the human, material, and financial resources needed to eliminate fistula in the DRC should be made available; and (3) medical and nursing staff should be sufficiently and effectively trained to minimize the number of unsuccessful surgeries performed on women with fistula.

O-234 Indication for fertility preservation in patients with endometriosis

Abstract Endometriosis is a complex gynecological condition that not only causes debilitating symptoms but also significantly impacts fertility. As the disease affects approximately 10% of women of reproductive age, addressing fertility preservation strategies becomes paramount. The conventional treatments for endometriosis, such as medical therapy and surgery, often fail to fully address its adverse effects on ovarian reserve and reproductive potential. Consequently, there is a growing interest in exploring fertility preservation options, particularly oocyte cryopreservation (OOC), for endometriosis patients. Despite the prevalence and impact of endometriosis on fertility, comprehensive data and guidelines specifically tailored to fertility preservation in this population remain scarce. The available evidence suggests that endometriosis, particularly when it involves ovarian endometriomas, is associated with a significant reduction in ovarian reserve, as indicated by lower levels of anti-Müllerian hormone (AMH). Surgical interventions, often necessary for managing endometriosis-related complications, can further compromise ovarian function and diminish fertility prospects. However, recent studies have shed light on the potential benefits of OOC in preserving fertility for endometriosis patients. OOC offers a minimally invasive approach with no impact on ovarian reserve compared to other fertility preservation techniques. Despite the lack of randomized controlled trials, our retrospective data have demonstrated promising outcomes, with a notable number needed to treat (NNT) of 16 for one successful pregnancy. This underscores the significance of discussing and considering OOC as part of the treatment plan for endometriosis patients, especially those at risk of ovarian compromise due to the disease or its management. The decision to pursue fertility preservation through OOC should be made on a case-by-case basis, taking into account various factors such as disease severity, patient age, ovarian reserve, and treatment history. French guidelines recommend considering OOC for endometriosis patients with bilateral ovarian endometriomas larger than 3 cm or those with endometriomas on a single ovary. Initiating fertility preservation discussions early, preferably before surgical intervention, allows patients to make informed decisions regarding their reproductive future. It is crucial to acknowledge the challenges and uncertainties associated with fertility preservation in endometriosis patients. Socio-economic factors, patient preferences, and the lack of clear criteria for selecting candidates for OOC pose significant hurdles. Furthermore, the effectiveness and cost-effectiveness of OOC in this population warrant further investigation. In addition to OOC, alternative fertility preservation options, such as ovarian tissue preservation, could be considered, particularly in cases where ovarian stimulation is not feasible or declined by the patient. However, data on the efficacy and safety of ovarian tissue preservation specifically in endometriosis patients are limited, highlighting the need for further research in this area. In conclusion, fertility preservation, particularly through OOC, holds promise for mitigating the adverse effects of endometriosis on ovarian function and fertility. While uncertainties persist, integrating fertility preservation discussions into the comprehensive management of endometriosis is essential. This ensures that patients are empowered to make informed decisions about their reproductive health and maximizes their chances of achieving desired fertility outcomes despite the challenges posed by endometriosis.