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Obstetrics and Gynegology2023№11
Modern possibilities for optimizing the...

Modern possibilities for optimizing the diagnosis and therapy of ovarian endometriomas

DOI
https://dx.doi.org/10.18565/aig.2023.168

Chernukha G.E., Pronina V.A., Solopova A.E.

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, Moscow, Russia

Ovarian endometrioma (OMA) is one of the most common forms of endometriosis and its prevalence is estimated to reach 50%. At the same time, OMA is mostly combined with other forms of endometriosis, namely, deep and peritoneal endometriosis; therefore, despite the high sensitivity of ultrasound diagnosis, it is often necessary to use magnetic resonance imaging (MRI). The review article presents the data from the national and foreign literature illustrating the impact of both OMA and its surgical treatment on the ovarian reserve. The article focuses on modern ideas about the possibility of conservative management of such patients including the oncological risks for them. The importance of MRI is considered not only for determining the prevalence of endometriosis and differential diagnosis of endometriomas with ovarian cancer, but also as a method for evaluating the effectiveness of suppressive hormone therapy.
Conclusion: In spite of the negative impact of OMA on the level of anti-muller hormone, the surgical treatment should be reasonably justified, since performing surgery can lead to irreversible decrease in ovarian reserve and significant risk for postoperative relapse if there is no subsequent prescription of suppressive hormone therapy. Currently, there is no clear evidence base for the possibility of long-term hormonal therapy for OMA in women of reproductive age in terms of oncological risks. Therefore, it is recommended to perform MRI in this group of patients not only as a method of verification of endometriomas and differential diagnosis of endometrioid ovarian cancer, but also as a possibility of predicting the effect of suppressive hormone therapy, including the use of a measurable diffusion coefficient.

Authors’ contributions: Pronina V.A. – obtaining data for analysis; Pronina V.A., Chernukha G.E. – writing the text of the article; Solopova A.E., Chernukha G.E. – editing.
Conflicts of interest: The authors declare no conflicts of interest.
Funding: The study was conducted without sponsorship.
For citation: Chernukha G.E., Pronina V.A., Solopova A.E. Modern possibilities for  optimizing the diagnosis and therapy of ovarian endometriomas.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2023; (11): 28-35 (in Russian)
https://dx.doi.org/10.18565/aig.2023.168

Keywords

endometriosis
ovarian endometriomas
magnetic resonance imaging (MRI)
suppressive hormone therapy
Full text (in Russian)

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Received 07.07.2023

Accepted 13.09.2023

About the Authors

Galina E. Chernukha, Dr. Med. Sci., Professor, Chief Researcher, obstetrician-gynecologist at the Department of Gynecological Endocrinology, Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, +7(985)999-60-00, c-galina1@yandex.ru,
https://orcid.org/0000-0002-9065-5689, 117997, Russia, Moscow, Ac. Oparin str., 4.
Veronika A. Pronina, obstetrician-gynecologist, PhD student, Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology,
Ministry of Health of Russia, +7(916)025-86-26, ver22595@yandex.ru, https://orcid.org/0000-0003-4566-4065, 117997, Russia, Moscow, Ac. Oparin str., 4.
Alina E. Solopova, Dr. Med. Sci., Associate Professor, Leading Researcher at the Department of Radiology, Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, +7(985)432-68-52, a_solopova@oparina4.ru, https://orcid.org/0000-0003-4768-115X,1
17997, Russia, Moscow, Ac. Oparin str., 4.
Corresponding author: Galina E. Chernukha, galina1@yandex.ru

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