Impact of Endometriotic Cyst Position on Infertility

Abstract

Endometriosis is one of the most common benign gynecologic disorders affecting reproductive health. There are many theories regarding how endometriosis affects fertility, but the exact mechanisms are still uncertain.

We evaluated 100 patients with unilateral ovarian endometriosis and infertility who underwent ovarian cystectomy. The women had at least one patent tube after surgery and were observed for spontaneous pregnancy for up to one year. Patients were divided into two groups according to the endometrioma position. The first group included 67 women with an endometriotic cyst in the left ovary, and the second group included 33 with an endometrioma in the right ovary. Groups were similar according to age, type of infertility, BMI, and size of the endometrioma.

The number of patients was significantly higher in the first group. Spontaneous pregnancy after cystectomy occurred in 28.4% of the patients with an endometrioma in left ovary, and in 9.1% with a right endometriotic cyst.

The better results regarding spontaneous conception with a left-sided endometrioma in our study are most likely related to the permeability of the fallopian tubes and adhesions in the Douglas pouch as a result of endometriosis. Further investigations are necessary to assess the influence of the laterality of endometriosis on infertility.