The impact of the resection of endometrioma on ovarian follicular reserve

Abstract

The ovarian endometrioma is a frequent occurrence, affecting women in the reproductive period. Their presence may decrease the ovarian follicular population; however, their surgical treatment can also bring negative impact on follicular reserve for resection of involuntary normal ovarian tissue. Excision of endometrioma laparoscopic treatment is preferred in terms of improvement in symptoms, increasing fertility and low recurrence compared with drainage associated with cauterization of the capsule. The dosage of the antimullerian hormone (AMH) and the antral follicle count (AFC) by ultrasonography have been reported as the best two parameters measuring the follicular reserve, and AMH as independent. There are also reports of decreased ovarian response in IVF treatments in ovarian endometriomas operated. Given the results of recent studies, it has been recommended the excision of endometrioma only in cases of pain, infertility or size greater than 4-5 cm in asymptomatic patients.