Fertility preservation in women with endometriosis: Oocyte cryopreservation and other techniques

• Published in: Best practice & research. Clinical obstetrics & gynaecology Vol. 95; p. 102503
• Main Authors: Gazzo, Irene, Moffa, Federica, Ferrero, Simone
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.07.2024
• Subjects: Cryopreservation - methods; Embryo cryopreservation; Endometriosis; Endometriosis - surgery; Female; Fertility preservation; Fertility Preservation - methods; Humans; Infertility, Female - etiology; Infertility, Female - prevention & control; Infertility, Female - therapy; Oocyte cryopreservation; Oocyte Retrieval - methods; Oocytes; Ovarian tissue cryopreservation; Ovary; Ovulation Induction - methods; Embryo cryopreservation; Endometriosis; Ovarian tissue cryopreservation; Fertility preservation; Oocyte cryopreservation
• ISSN: 1521-6934; 1532-1932; 1532-1932
• DOI: 10.1016/j.bpobgyn.2024.102503

In recent years, advancements in cryopreservation techniques for oocytes, embryos, and ovarian tissue have enabled offering fertility preservation (FP) options to women with endometriosis. It is recommended to always conduct specialized counselling on FP, especially before considering surgical interventions for endometriosis. The decision regarding the methods of FP, the timing, and to which women affected by endometriosis these techniques should be offered are still subjects of discussion. However, several studies suggest that it can be proposed before surgical interventions for endometriosis, particularly if the patient is undergoing mono or bilateral endometrioma surgery. The most recommended technique is ovarian stimulation, followed by oocyte cryopreservation. Nevertheless, the literature contains various studies describing FP through embryo cryopreservation or the retrieval and cryopreservation of ovarian tissue. [Display omitted] •There is a lack of clinical consensus for identifying patients with endometriosis who should be counselled to consider fertility preservation.•Fertility preservation is advisable in patients with large and/or bilateral endometriomas and previous ovarian surgery.•The success rates of oocyte cryopreservation vary based on age, ovarian reserve, and surgical history.•Embryo cryopreservation requires the male gamete and has ethical and legal implications for death or separation.•Ovarian tissue cryopreservation is a valuable option for patients who cannot undergo controlled ovarian stimulation for urgent surgery.