Algorithm for overcoming infertility secondary to ovarian endometriotic cyst: a view of a reproductive specialist and a surgeon


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Aim. To investigate the demand and effectiveness of algorithms for the management of infertility using IVF and surgical methods in women with ovarian endometriotic cysts (OEC) on a case-by-case basis, taking into account the OEC manifestations and clinical presentations associated with age, ovarian reserve, and concomitant indications for IVF. Materials and methods. The study analyzed clinical spectrum OEC in 532 infertile women regarding the distribution of patients by age, ovarian reserve, and the presence of concomitant indications for IVF. The study compared the demand and effectiveness of three algorithms selected based on the OEC characteristics and clinical status affecting the reproductive potential. Results. The most popular algorithm (80.3%) for the management of infertility in women with OEC was IVF’s initial administration, which resulted in a cumulative pregnancy rate (PR) of 86.7%. Algorithms with the initial use of surgery to create conditions for spontaneous pregnancy or to prepare for urgent IVF were in demand in 11.4% and 8.3% of cases, respectively. They had 93.4% and 36.4% cumulative PR, respectively. Conclusion. The selection of the optimal algorithm for the management of infertility using IVF and surgical methods in women with OEC requires considering the age, ovarian reserve, and concomitant indications for IVF and the features of the detected OECs. The widespread use of cryopreservation technology allows the re-transfer of embryos without ovarian stimulation (thus reducing the program’s overall cost). It implies the possibility of continuing fertility treatment in cases of surgical menopause after OEC removal.

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作者简介

Ksenia Krasnopolskaya

Moscow Regional Research Institute of Obstetrics and Gynecology

Email: deti222@mail.ru
Corr. Member of the RAS, Professor, Head of the Department of Reproduction

Alexander Popov

Moscow Regional Research Institute of Obstetrics and Gynecology

Email: gyn_endoscopy@mail.ru
Dr. Med. Sci., Professor, Head of the Department of Endoscopic Surgery

Anton Fedorov

Moscow Regional Research Institute of Obstetrics and Gynecology

Email: gyn_endoscopy@mail.ru
Ph.D., Leading Researcher at the Department of Endoscopic Surgery

Irina Ershova

Moscow Regional Research Institute of Obstetrics and Gynecology

Email: deti222@mail.ru
Ph.D., Researcher at the Department of Reproduction

参考

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