Özcan Pınar, Varlı Bulut, Sarıdoğan Ertan, Oral Engin, Mabrouk Muhammed, Usta Taner, Constantin Alin Stefan
Department of Obstetrics and Gynecology, Uskudar University School of Medicine, 34768 Istanbul, Türkiye.
Department of Obstetrics and Gynecology, Ankara University School of Medicine, 06620 Ankara, Türkiye.
J Clin Med. 2025 Mar 21;14(7):2147. doi: 10.3390/jcm14072147.
Ovarian endometriomas (OEMs), cystic formations within the ovaries, are a significant manifestation of endometriosis and present in 20-40% of affected women. Despite extensive research, the pathogenesis of endometriosis remains unclear, with retrograde menstruation, coelomic metaplasia, and lymphatic dissemination being proposed mechanisms. OEMs negatively impact ovarian function by reducing the ovarian reserve, disrupting folliculogenesis, and altering the ovarian microenvironment through oxidative stress, inflammation, and fibrosis. Elevated reactive oxygen species (ROS) accelerate follicular atresia, and extracellular matrix remodeling contributes to ovarian damage, while immune dysregulation and cytokine imbalances further exacerbate the condition. The presence of OEMs does not significantly affect live birth rates in in vitro fertilization (IVF) treatments, despite potential reductions in the quality and quantity of oocytes. However, their surgical excision compromises the ovarian reserve. This review highlights the complex mechanisms by which OEMs impair ovarian function and emphasizes the need for further research to develop strategies that mitigate these effects, ultimately improving reproductive outcomes for women with endometriomas.
卵巢子宫内膜异位囊肿（OEMs）是卵巢内的囊性结构，是子宫内膜异位症的一种重要表现，在20%至40%的患病女性中出现。尽管进行了广泛研究，但子宫内膜异位症的发病机制仍不清楚，逆行月经、体腔化生和淋巴扩散被认为是可能的机制。OEMs通过减少卵巢储备、扰乱卵泡发生以及通过氧化应激、炎症和纤维化改变卵巢微环境，对卵巢功能产生负面影响。活性氧（ROS）水平升高加速卵泡闭锁，细胞外基质重塑导致卵巢损伤，而免疫失调和细胞因子失衡进一步加重病情。尽管OEMs的存在可能会降低卵母细胞的质量和数量，但对体外受精（IVF）治疗中的活产率没有显著影响。然而，手术切除这些囊肿会损害卵巢储备。本综述强调了OEMs损害卵巢功能的复杂机制，并强调需要进一步研究以制定减轻这些影响的策略，最终改善患有子宫内膜异位囊肿女性的生殖结局。
