The Impact of Laparoscopic Excision Versus Ablation of Ovarian Endometrioma on Ovarian Reserve: RCT

Abstract

ndometriosis is a common condition associated with pelvic pain and infertility in women. Endometriosis is defined as the presence of ectopic deposits of endometrial tissue usually, but not exclusively, limited to the pelvis, which may lead to infertility and pelvic pain. It may be present in up to 22% of asymptomatic women and up to 45% of women with pelvic pain. It has been believed for almost a century by the majority of academic opinion that endometriosis is a disease caused by shedding of menstrual endometrium and its dissemination throughout the pelvis. Endometrioma are endometriotic deposits within the ovary. The origin of ovarian endometrioma is unknown; however, most authors believe that they result initially from a deposit of endometrium passed through the Fallopian tube, causing adherence of the ovary to the pelvic peritoneum and progressive invagination (folding inwards) of the ovary. If this is true, an endometrioma would be a pseudocyst (false cyst), the wall of which is the inverted ovarian cortex (centre) and hence the removal of this cyst wall might involve removal of normal ovarian tissue, with possible adverse implications for future fertility.