title: Controversies in the Management of Endometrioma: To Cure Sometimes, to Treat Often, to Comfort Always?
abstract: Endometriomas are common in reproductive-aged women, but controversy exists regarding their management. PubMed was searched to identify pertinent studies on outcomes of medical and surgical management of endometrioma, with focus on randomized controlled trials and meta-analyses. Surgical excision is more effective than fenestration/coagulation of endometrioma for pelvic pain but decreases antimullerian hormone. It may modestly improve the chances of spontaneous pregnancy, but does not impact chances of success with in vitro fertilization. Oral contraceptive pills improve dysmenorrhea but not dyspareunia or noncyclic pelvic pain. Management of the patient with endometrioma should be individualized based on each patient's particular symptoms and short-term and long-term fertility goals.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Utah, Salt Lake City, Utah.
authors.forename: Erica B
authors.initials: EB
authors.lastname: Johnstone
authors.forename: Megan H
authors.initials: MH
authors.lastname: Link
mesh_terms: D003276:Contraceptives, Oral / Q000627:therapeutic use*; D004412:Dysmenorrhea / Q000209:etiology; D004414:Dyspareunia / Q000209:etiology; D004715:Endometriosis / Q000150:complications / Q000188:drug therapy* / Q000601:surgery*; D005260:Female; D005298:Fertility; D005307:Fertilization in Vitro; D006801:Humans; D007247:Infertility, Female / Q000150:complications / Q000628:therapy; D015201:Meta-Analysis as Topic; D010049:Ovarian Diseases / Q000150:complications / Q000188:drug therapy* / Q000601:surgery*; D065851:Ovarian Reserve; D017699:Pelvic Pain / Q000209:etiology; D011247:Pregnancy; D018873:Pregnancy Rate; D016032:Randomized Controlled Trials as Topic
chemical_list: D003276:Contraceptives, Oral