Jiang Danni, Nie Xiaocui
Graduate School, Dalian Medical University, Dalian, Liaoning 116044, P.R. China.
Department of Gynecology, Shenyang Women's and Children's Hospital, Shenyang, Liaoning 110011, P.R. China.
Exp Ther Med. 2020 Nov;20(5):114. doi: 10.3892/etm.2020.9242. Epub 2020 Sep 18.
Endometrioma is the cystic lesion of ovaries originating from endometrial glands and stroma; it is identified in 17-44% of patients with endometriosis. Numerous existing studies have reported the association between endometrioma and infertility. However, an absolute cause-effect association requires further confirmation. Available evidence has suggested that ovarian reserve may be impaired by spatial occupation influences, local reaction or both, affecting the reproductive health of females. Given the increased focus on the pathophysiological mechanisms of endometrioma, surgical excision has commonly been considered to avoid further ovarian damage. However, the potential adverse effect of this surgery on the ovarian reserve has recently become a focal point. Whether or not surgical excision can facilitate subsequent conception in young females planning to be pregnant is controversial. As shown in the present review on the effects of endometrioma and its removal in females requiring assisted reproductive technology, prior surgery for endometrioma may not improve assisted fertility results and may further decrease the number of oocytes retrieved in the affected females. Subsequent studies are needed to ascertain the optimal management of infertility in the setting of endometriomas.
卵巢子宫内膜异位囊肿是起源于子宫内膜腺体和间质的卵巢囊性病变；在17%至44%的子宫内膜异位症患者中可发现该病变。众多现有研究报道了卵巢子宫内膜异位囊肿与不孕症之间的关联。然而，绝对的因果关联尚需进一步证实。现有证据表明，卵巢储备功能可能会受到空间占位影响、局部反应或两者共同作用的损害，进而影响女性的生殖健康。鉴于对卵巢子宫内膜异位囊肿病理生理机制的关注度不断提高，手术切除通常被认为可避免对卵巢造成进一步损害。然而，该手术对卵巢储备功能的潜在不良影响最近已成为一个焦点问题。对于计划怀孕的年轻女性，手术切除是否能促进后续受孕存在争议。正如本次关于卵巢子宫内膜异位囊肿及其切除对需要辅助生殖技术的女性的影响的综述所示，先前进行的卵巢子宫内膜异位囊肿手术可能无法改善辅助生育结果，反而可能进一步减少受影响女性获取的卵母细胞数量。后续研究需要确定卵巢子宫内膜异位囊肿情况下不孕症的最佳管理方法。
