Personified Approach To Fertility Restoration In Women After Surgery On Ovarian Endometriosis
Abstract
Study aimed to analyze and substantiate a personified (individualized) approach to fertility restoration in women after surgical treatment of ovarian endometriosis, with emphasis on minimizing damage to ovarian reserve and improving reproductive outcomes. An analytical review of modern scientific literature was conducted for the period 2018–2025. The search was performed in PubMed, MEDLINE, Cochrane Library, Google Scholar, and eLIBRARY.ru databases, as well as in clinical guidelines of ESHRE, ASRM, and World Endometriosis Society. Laparoscopic cystectomy leads to a significant reduction in anti-Müllerian hormone (AMH) levels: 30–45% in unilateral and 50–70% in bilateral cases. Ablative techniques better preserve ovarian reserve (AMH reduction 10–25%) but are associated with a higher recurrence rate (25–45%). A personified approach considering patient age, baseline ovarian reserve, extent of disease, reproductive plans, and psychosocial factors increases spontaneous pregnancy rates to 15–35% and improves IVF outcomes. The personified approach is the most effective strategy for fertility restoration after surgery for ovarian endometriosis. Its implementation, based on comprehensive preoperative assessment of ovarian reserve and individualized selection of surgical and reproductive tactics, allows minimization of iatrogenic damage and significant improvement of reproductive outcomes.
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