N 2 (199) 2026. P. 81–91

IMPACT OF ENDOMETRIOSIS ON OVARIAN RESERVE AND FEMALE REPRODUCTIVE FUNCTION: A REVIEW OF CURRENT EVIDENCE

A. G. Volianska, H. V. Shytova, G. L. Lavrynenko, O. Yu. Kormilets

Odesa National Medical University, Odesa, Ukraine

DOI 10.32782/2226-2008-2026-2-12

Objective. To evaluate the impact of endometriosis on ovarian reserve and to analyze the mechanisms underlying its detrimental effects on ovarian function based on current literature.

Materials and Methods. This review included original studies, systematic reviews, meta-analyses, and clinical guidelines published in Ukrainian and English. Relevant publications were identified by searching PubMed, Scopus, Google Scholar, and the Cochrane Library using keywords such as endometriosis, fertility, pathophysiology, endometrioma, ovarian reserve, and surgery.

Results and Discussion. The review summarizes current evidence on endometriosis-associated infertility, focusing on the impact of endometriomas on ovarian reserve. Ovarian endometriosis negatively affects ovarian reserve and reproductive outcomes. Anti-Müllerian hormone (AMH) is a key marker in clinical assessment. Most studies demonstrate reduced AMH levels in patients with endometriomas even before surgery, indicating primary ovarian damage caused by chronic inflammation, oxidative stress, fibrosis, and mechanical follicular loss. Comparative analyses show that combined surgical approaches are associated with lower recurrence rates and higher spontaneous pregnancy rates than ablative techniques. However, reproductive prognosis should not rely solely on AMH. Evidence suggests its limited predictive value for spontaneous conception, while a comprehensive assessment of infertility factors provides more accurate prediction of reproductive outcomes.

Conclusions. Endometriosis-associated infertility is multifactorial. Management should be individualized and based on an integrated evaluation of clinical, historical, hormonal, ultrasonographic, and surgical factors to improve reproductive outcomes.

Keywords: endometriosis, infertility, gynecologic surgery, gynecology, gynecological surgery.

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