Surgical treatment of endometriomas and ovarian reserve

Objective: To present an overview of affect an ovarian reserve in women after laparoscopic surgery for ovarian endometriosis. Subject: Review. Setting: Department of Obstetric and Gynecology, Hospital Kyjov; Department of Obstetric and Gynecology, University Hospital, Brno. Methods: Summary of the results of recent studies. Results: The decrease in ovarian reserve has been detected in 8 of 9 evaluated studies, specifically in one retrospective study, six prospective studies and in one systematic review, the results of the meta-analysis don't prove the reduction of ovarian reserve after the surgery for endometrioma, reduced ovarian reserve evaluated by the antral follicle count has been proven in the affect ovary before the surgery. Conclusion: Endometriosis is among the most frequent benign gynecological diseases, affecting the women in reproductive age. Laparoscopic surgery techniques are currently the method of choice in the treatment of endometriotic ovarian cysts. Excision of endometriotic cyst is associated with significant reduction in ovarian reserve. The women with previous surgery of endometrioma have significantly fewer mature oocytes capable of fertilization, the ovarian response to stimulation is reduced and the number of live births is lower.