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Updated: May 19, 2026
Surgical Techniques to Optimize Ovarian Reserve during Laparoscopic Cystectomy for Ovarian Endometrioma
Published on: January 22, 2022
Controversies in the management of endometriomas in patients undergoing assisted reproduction
Charalampos Siristatidis1, Charalampos Chrelias, Vasileios D Sioulas
1Assisted Reproduction Unit, 3rd Department of Obstetrics and Gynecology, University of Athens, Attikon Hospital, 1 Rimini Street, Chaidari, 12462, Athens, Greece.
Introduction:
The presence of an endometrioma has been proposed to affect the ovarian function in a negative way. Our aim was to present the key evidence on multiple aspects of endometriomas' management in subfertile couples scheduled for assisted reproduction technologies (ART).
Materials And Methods:
A critical review of the existing literature was performed focusing on the need of endometrioma treatment prior to ART, the relevant options, the potentially participating surgeon's characteristics and the socioeconomic perspective.
Results:
To date, we have no definitive data to suggest whether the damage to the ovaries observed in women with endometriomas may be related to the mere presence of the cyst, the surgical procedure to remove it, the combination of the two, or factors currently unknown. Moreover, there is no conclusive evidence that, for subfertile couples, removal of endometriomas increases the chance of having a baby. The uncertainty regarding the best treatment strategy and factors such as the limited number of tertiary centers for laparoscopic surgery throughout the world seems to further complicate the decision.
Conclusions:
Until research addresses the current "grey areas", the management of endometriomas in patients undergoing ART should be individualized and take into consideration numerous parameters.
