Is it necessary to operate cysts caused by endometriosis before undergoing an assisted reproduction treatment? (21/03/16)

Endometriosis is a chronic disease affecting 5% of women during their fertile years. The symptoms could be pain during menstruation and excessive bleeding, pelvic or abdominal pain, pain during sexual intercourse and cysts in the ovaries may appear.

Symptoms can be irritating and debilitating, these can be treated with medication, hormonal treatments or even surgery depending on the case, and if the woman wants to become pregnant in the future.

Endometriosis is associated with 25% of female infertility cases. Women suffering with endometriosis and having issues to become pregnant can undergo an assisted reproduction treatment.

The question is, if surgery to remove the cysts caused by endometrioses is necessary before an in vitro fertilisation cycle. Experts are becoming more reluctant to it and would consider surgery only if the cyst is very big or obstructing the tubes.

Dr Carles Catllà, of Institut Marquès, explains that “during surgery of a cyst caused by endometriosis, there is the risk of eliminating follicles from the ovarian cortex, reducing the ovarian reserve of the woman and therefore reducing the chances of pregnancy. For this reason in most cases IVF is carried out without previous surgery”.

After IVF, the usual checks will be carried out –and if the woman doesn’t want to have more children– the doctor will decide if surgery is necessary in that particular case.

March is the month dedicated to Endometriosis, with different activities to raise awareness of this common disease but still not very well known.