Overcoming Endometriosis: Surgical Breakthroughs and Fertility Solutions at Pelargos IVF

02 Jan Overcoming Endometriosis: Surgical Breakthroughs and Fertility Solutions at Pelargos IVF

Endometriosis is a complex condition affecting millions of women worldwide, often causing pain and infertility. For patients trying to conceive, surgical treatment plays a crucial role. This article explores the impact of surgery on fertility in endometriosis patients, available techniques, and factors influencing success.

Understanding Endometriosis and Its Impact on Fertility

Endometriosis, affecting approximately 1 in 10 women of reproductive age (Surrey et al., 2020), occurs when tissue similar to the uterine lining grows outside the uterus. This growth often involves the ovaries, fallopian tubes, and pelvic peritoneum, leading to inflammation, scarring, and anatomical distortions. These complications can negatively affect fertility in several ways:

• Adhesions and Scarring: These can block fallopian tubes or distort pelvic anatomy, preventing the egg and sperm from meeting.
• Ovarian Endometriomas: Cysts on the ovaries may reduce ovarian reserve and impair egg quality.
• Inflammation: Chronic inflammation in the pelvis can harm egg and sperm function and hinder embryo implantation.

Surgical Options for Endometriosis-Related Infertility

Surgical intervention aims to restore pelvic anatomy, remove endometriosis lesions, and improve fertility outcomes. The primary techniques are:

1. Laparoscopy
   • A minimally invasive procedure allowing surgeons to visualize and remove endometriosis lesions.
   • Considered the gold standard for diagnosing and treating endometriosis.
   • Techniques include excision (removing lesions) and ablation (destroying lesions).
2. Laparotomy
   • An open surgical approach, typically reserved for severe cases or when laparoscopy is not feasible.

At Pelargos IVF, our emphasis on skilled surgical expertise ensures precise lesion removal, which is crucial for improving fertility outcomes.

How Surgery Improves Fertility

• Improved Ovarian Function: Removing ovarian endometriomas can help preserve ovarian reserve and enhance egg quality.
• Restored Tubal Patency: Clearing adhesions can reopen blocked fallopian tubes, enabling natural conception.
• Reduced Inflammation: Removing lesions decreases inflammation, improving embryo implantation chances.

Factors Affecting Surgical Success

Several factors influence the effectiveness of surgery:

• Severity of Endometriosis: Surgery is more beneficial for mild to moderate cases (Stage I-II) than severe cases (Stage III-IV).
• Age: Younger patients typically have better post-surgical outcomes due to better ovarian reserve and egg quality.
• Ovarian Reserve: Pre-surgical evaluation is essential. Advanced surgical techniques help minimize ovarian damage during lesion removal.

Post-Surgical Considerations

• Natural Conception: Many women achieve pregnancy naturally within 6–12 months post-surgery. If not, assisted reproductive techniques (ART) may be recommended.
• Assisted Reproductive Techniques: IVF may be more effective for patients with diminished ovarian reserve or recurrent endometriosis. Surgery optimizes conditions before IVF.
• Hormonal Suppression: Hormonal therapy may be prescribed post-surgery to reduce recurrence risk before attempting conception.

The Role of Multidisciplinary Care

At Pelargos IVF, we adopt a multidisciplinary approach to managing endometriosis-related infertility. Our team combines surgical expertise and personalized fertility treatments to ensure optimal outcomes. Tailored plans include:

• Pre-surgical assessments to evaluate ovarian reserve and tubal patency.
• Precision surgical techniques to maximize fertility preservation.
• Post-surgical guidance on timing conception and transitioning to ART if needed.

Emerging Research and Innovations

Advancements in endometriosis and fertility research include:

• Robotic-Assisted Surgery: Offers enhanced precision in lesion removal. However, laparoscopic surgery by skilled surgeons remains the gold standard for cost-effectiveness.
• Biomarkers for Recurrence: Help identify patients at risk, guiding post-surgical management.
• Fertility Preservation Techniques: Cryopreservation of eggs or embryos is an option for patients at high risk of ovarian reserve loss.

Conclusion

Surgical treatment for endometriosis can significantly enhance fertility outcomes. Success depends on various factors, including disease severity, surgical expertise, and post-operative care.

At Pelargos IVF, our advanced surgical techniques, performed in a state-of-the-art Day Surgery Unit located within a prominent maternity hospital, are complemented by tailored fertility treatments and special endometriosis IVF protocols. We are dedicated to helping our patients achieve their dream of parenthood.

If you’re struggling with endometriosis-related infertility, our team is here to guide you every step of the way.

---

References

• – Adamson, G. D., & Pasta, D. J. (2010). Endometriosis fertility index: The new, validated endometriosis staging system. Fertility and Sterility, 94(5), 1609-1615. https://doi.org/10.1016/j.fertnstert.2009.09.035
• – Chapron, C., Marcellin, L., Borghese, B., & Santulli, P. (2019). Rethinking mechanisms, diagnosis, and management of endometriosis. Nature Reviews Endocrinology, 15(11), 666–682. https://doi.org/10.1038/s41574-019-0245-z
• – Johnson, N. P., & Hummelshoj, L. (2013). Consensus on current management of endometriosis. Human Reproduction, 28(6), 1552-1568. https://doi.org/10.1093/humrep/det050
• – Somigliana, E., Infantino, M., Benedetti, F., Arnoldi, M., Calanna, G., & Ragni, G. (2010). The presence of ovarian endometriomas is associated with a reduced responsiveness to gonadotropins. Fertility and Sterility, 93(1), 74-78. https://doi.org/10.1016/j.fertnstert.2008.09.048

Surrey, E., Soliman, A. M., Agarwal, S. K., Potts, E., & Ryan, I. P. (2020). Impact of endometriosis diagnostic delays on patient burden. Fertility and Sterility, 113(2), 343-350. https://doi.org/10.1016/j.fertnstert.2019.10.034