"📌 Fertility in Patients with Endometriosis..."

Especially in patients with endometriosis who desire to have children, we aim to assess these patients separately before initiating medical (drug) or surgical (surgery) treatments. In order to preserve fertility, we prefer to implement certain treatments before resorting to surgical or medical interventions.

As you may know, endometriosis, commonly referred to as a chocolate cyst, is a condition where the tissue that normally lines the inside of the uterus, known as endometrium, grows outside the uterus on the walls of the pelvic cavity or other reproductive organs, a condition called adenomyosis when it occurs within the uterine muscle wall. Patients typically present with complaints of pain or fertility issues. In cases where patients desire to conceive, it is essential to assess ovarian reserve, evaluate the functionality and openness of the fallopian tubes, and investigate whether there are any hindrances to holding the child within the uterus.

We prefer to see and manage these patients before performing surgery to preserve fertility. Depending on the ovarian reserve of the patients, we may offer ovarian stimulation treatments. If the fallopian tubes are open, we may proceed with less invasive treatments such as intrauterine insemination (IUI) or escalate to more intensive interventions, including in vitro fertilization (IVF).

In cases where IVF is planned, after administering medications to stimulate ovulation, we aim to retrieve the developing follicles, ideally without touching the endometriomas or chocolate cysts, under anesthesia and guided by ultrasound. During the procedure, we avoid touching the chocolate cysts to prevent potential harm to the eggs due to the toxic environment within the cyst. Additionally, avoiding contact with endometriomas during IVF procedures helps reduce the risk of complications such as infections, like abscesses.

Thanks... There is always hope.