Determination of treatment policy for infertility in patients with ovarian endometrioid cysts
There are three methods to overcome infertility in ovarian endometrioid cysts: assisted reproductive technologies through in vitro fertilization, surgical or medical treatment followed by expectant management, and surgical treatment followed by the use of assisted reproductive technologies. In vitro fertilization with cycle segmentation also increases fertility: surgical and medical treatment in a cryoprotocol is performed before embryo transfer. Minimally invasive treatment, such as ultrasound-guided transvaginal puncture and aspiration of a cyst with or without sclerosis, is used as an alternative to laparoscopic cystectomy. The rate of relapses can be reduced, by using 96% ethanol that acts as a sclerosing agent for the cyst bed for 15 minutes, which causes its obliteration. Cryopreservation of oocytes, embryos, or ovarian tissue may be offered to a number of patients in terms of a higher risk for infection of the pelvic organs during material sampling. Repeat surgical treatment is not recommended due to diminished ovarian reserve: it is advisable to use assisted reproductive technologies in case of recurrence.Lavrukhina M.A.
Conclusion: The choice of a fertility-preserving treatment for ovarian endometriosis depends on the patient’s age, her ovarian reserve, medical history, and desire for the time of pregnancy onset.
Keywords
ovarian endometrioid cysts
infertility
laparoscopic cystectomy
transvaginal aspiration
sclerosing
assisted reproductive technologies for ovarian endometriosis
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Received 07.02.2022
Accepted 15.03.2022
About the Authors
Maria A. Lavrukhina, 4th year student, N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, +7(977)575-80-18,maria.alexandrovna05@mail.ru, 117997, Russian Federation, Moscow, Ostrovityanova str., 1.
Conflicts of interest: The author declares that there are no possible conflicts of interest.
Funding: The investigation has not been sponsored.
For citation: Lavrukhina M.A. Determination of treatment policy
for infertility in patients with ovarian endometrioid cysts.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2022; 5: 23-29 (in Russian)
https://dx.doi.org/10.18565/aig.2022.5.23-29