FEATURES OF THE COURSE OF ENDOMETRIOSIS IN WOMEN WITH OVARIAN ENDOMETRIOMAS AND IMPACT ON REPRODUCTIVE FUNCTION
DOI:
https://doi.org/10.11603/24116-4944.2025.2.15799Keywords:
endometriosis, endometrioma, infertility, laparoscopic cystectomy, gonadotropin-releasing hormone agonists, chronic pelvic pain, ovarian reserve, anti-Mullerian hormoneAbstract
The aim of the study – to compare the features of the course of endometriosis and the impact on reproductive function according to retrospective analysis in patients with ovarian endometriomas with and without surgical treatment.
Materials and Methods. A retrospective analysis of medical records of inpatients at the medical center «Innomed» was conducted. The study included 140 women of reproductive age who were treated for ovarian endometriomas. Four groups were formed: the first group included 41 patients with ovarian endometriomas who underwent laparoscopic cystectomy with the administration of releasing hormone agonists, the second group included 37 patients without the administration of a-GnRH after laparoscopic cystectomy. The third group was formed by 32 patients with ovarian endometriomas without surgical treatment. The fourth group was the control group (30 women of reproductive age with tubal infertility). The age, duration and form of infertility, the main clinical signs of endometriosis were studied, and a comparison was made between the groups of patients with ovarian endometriomas with and without surgical treatment.
Results and Discussion. The age of the women ranged from 25 to 37 years, and the duration of infertility ranged from 1 to 8 years. The risk of recurrence of endometriomas increased over time, with a significantly higher value recorded after 2 years.
One year after the surgery in the first group of women with ovarian endometriomas, the recurrence was at 9.76 %, while in the second group – 29.73 %. Two years after the surgical treatment, the frequency of recurrence of ovarian endometriomas was 17.07 % in the first and 40.54 % in the second study groups.
Conclusions. Based on the analysis, it was found that the use of GnRH agonists before laparoscopic cystectomy for endometrioma reduces the recurrence rate within 1–2 years after surgery and improves clinical symptoms, although it is accompanied by a certain decrease in ovarian reserve. In patients who underwent laparoscopic cystectomy alone, the recurrence rate was higher, and the decrease in ovarian reserve was similar. Women without surgical treatment had more pronounced manifestations of endometriosis and decreased ovarian reserve, which is associated with the long-term negative impact of endometrioma on ovarian tissue.
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