Ovarian Endometrioma –Related Infertility A Cros-Sectional Based Study In Tishreen University Hospital In Lattakia
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الكيسات الشوكولاتيةAbstract
In a population of operated patients with histologically proven endometriosis, ovarian endometrioma (OMA) per se is not associated with an increased risk of presentation with infertility, while previous surgery for endometriosis was identified as a risk factor for infertility what is known already: The increased prevalence of endometriosis among subfertile women indicates that endometriosis impairs
reproduction for reasons that are not completely understood
study design, size, duration: Thiswas an observational, cross-sectional study using data prospectively collected in all non-pregnant patients aged between 18 and 42 years ,whowere surgically explored for benign gynaecological conditions atour institution between January 2022
and January 2024. For each patient, a standardized questionnaire was completed during a face-to-face interview conducted by the surgeon during the month preceding surgery
participants/materials, setting, methods: Surgery was performed in 193 patients, of which 100 signed their informed consent. Of the 51women with a visual diagnosis of endometriosis, 42 had histologically proven endometriosis and complete treatment
for their endometriotic lesions, including 15 who presented with infertility. Univariate analysis and multiple logistic regression analysis were performed to determine factors associated with infertility
main results and the role of chance: The following variables were identified as risk factors for endometriosis-related infertility: age .32 years (odds ratio [OR] ¼ 1.9; 95% confidence interval [CI]: 1.4–2.4), previous surgery for endometriosis (OR ¼ 1.9; 95% CI: 1.3–2.2), as well as peritoneal superficial endometriosis (OR ¼ 3.1; 95% CI: 1.9–4.9); Conversely, previous pregnancy was associated with a lower rate of infertility (OR ¼ 0.7; 95% CI: 0.6–0.9 and OR ¼ 0.6; 95% CI: 0.4–0.9, respectively). OMA is not selected as a significant
risk factor for infertility limitations, reason for caution: The selection of our study population was based on a surgical diagnosis. We cannot exclude that infertile women with OMA associated with a diminished ovarian reserve, as assessed during their infertility work-up, were referred less frequently to surgery and might therefore be underrepresented.
Identification of risk and preventive factors of endometriosis-related infertility can help improve clinical and surgical management of endometriosis in the setting of infertility
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