To date, the question of choosing the optimal treatment for endometrioid cysts in infertile women remains relevant. The ovarian reserve of such women is influenced by both the endometrioma itself and the surgery to remove it. This paper provides an analysis of the literature and an overview of modern approaches to the treatment of endometrioid ovarian cysts concerning preserving or restoring fertility. The endometrioma influence on the ovarian anatomy and physiology is considered. The comparison of the surgical approach with minimally invasive techniques: aspiration, sclerotherapy of endometrioid cysts is provided. Attention is paid to the effectiveness of assisted reproductive technology in patients after the endometrioma treatment by different methods.

The effectiveness of assisted reproductive technology (ART) programs in patients after surgical treatment of endometrioid ovarian cyst (EOC) and after transvaginal EOC was compared. The study group consisted of 47 patients who underwent the ART program after EOC puncture, and 48 patients who entered the ART program after surgical treatment of EOC by laparoscopic exfoliation of the cyst capsule using electrocoagulation. The control group consisted of 50 patients with male factor infertility. The results of the study showed that in the group of punctured patients, the timing of entry into ART programs is significantly less than in the surgical treatment of EOC. The number of obtained oocytes, zygotes and blastocysts of good quality is statistically higher in the group of punctured patients compared to the operated patients and is comparable with the control group. The «Baby take-home rate» did not differ in the group of dotted patients and in the control group, while significantly decreasing after laparoscopy.

The effectiveness of assisted reproductive technology (ART) programs in patients after surgical treatment of endometrioid ovarian cyst (EOC) and after transvaginal EOC was compared. The study group consisted of 47 patients who underwent the ART program after EOC puncture, and 48 patients who entered the ART program after surgical treatment of EOC by laparoscopic exfoliation of the cyst capsule using electrocoagulation. The control group consisted of 50 patients with male factor infertility. The results of the study showed that in the group of punctured patients, the timing of entry into ART programs is significantly less than in the surgical treatment of EOC. The number of obtained oocytes, zygotes and blastocysts of good quality is statistically higher in the group of punctured patients compared to the operated patients and is comparable with the control group. The «Baby take-home rate» did not differ in the group of dotted patients and in the control group, while significantly decreasing after laparoscopy.

The aim of the research: to evaluate the effect of transvaginal punction of the endometrioid cyst on the ovarian reserve of patients with infertility. Materials and methods: the study analyzed 65 patients who were planning ART programs and underwent unilateral endometriod cyst puncture with a volume of up to 40 mm, and 69 patients who were operated on in the volume of endometrioma capsule exfoliation with a diameter of up to 40 mm. Before and after the interventions, the parameters of the hormones AMH and FSH, the number of antral follicles (NAF), the volume of the ovary, and the level of the cancer marker CA-125 were evaluated. Results: after the punction, in contrast to the operation, there was no significant decrease in AMH and NAF parameters. The level of FSH also did not change between the punctated patients, while the operated patients showed an increase in FSH from 6.7 ± 0.5 to 9.1 ± 0.4 mME/ml, a decrease in AMH from 2.0 ± 0.3 to 1.1 ± 0.1 ng/ml, and a decrease in NAF from 8.1 ± 0.7 to 4.0 ± 0.8 three months after surgery. The average values of AMH, FSH, and NAF remained unchanged in the group of punctated patients. Conclusion: it has been shown that cyst punction does not reduce ovarian reserve, in contrast to laparoscopic cystectomy, and can be considered as an alternative approach for women with endometriod cyst planning ART. Puncture and aspiration of the contents of the endometriod cyst can serve as a factor in the rapid onset of pregnancy, which in itself is an alternative to hormonal treatment of endometriosis.

The aim of the research: to evaluate the effect of transvaginal punction of the endometrioid cyst on the ovarian reserve of patients with infertility. Materials and methods: the study analyzed 65 patients who were planning ART programs and underwent unilateral endometriod cyst puncture with a volume of up to 40 mm, and 69 patients who were operated on in the volume of endometrioma capsule exfoliation with a diameter of up to 40 mm. Before and after the interventions, the parameters of the hormones AMH and FSH, the number of antral follicles (NAF), the volume of the ovary, and the level of the cancer marker CA-125 were evaluated. Results: after the punction, in contrast to the operation, there was no significant decrease in AMH and NAF parameters. The level of FSH also did not change between the punctated patients, while the operated patients showed an increase in FSH from 6.7 ± 0.5 to 9.1 ± 0.4 mME/ml, a decrease in AMH from 2.0 ± 0.3 to 1.1 ± 0.1 ng/ml, and a decrease in NAF from 8.1 ± 0.7 to 4.0 ± 0.8 three months after surgery. The average values of AMH, FSH, and NAF remained unchanged in the group of punctated patients. Conclusion: it has been shown that cyst punction does not reduce ovarian reserve, in contrast to laparoscopic cystectomy, and can be considered as an alternative approach for women with endometriod cyst planning ART. Puncture and aspiration of the contents of the endometriod cyst can serve as a factor in the rapid onset of pregnancy, which in itself is an alternative to hormonal treatment of endometriosis.

To date, the question of choosing the optimal treatment for endometrioid cysts in infertile women remains relevant. The ovarian reserve of such women is influenced by both the endometrioma itself and the surgery to remove it. This paper provides an analysis of the literature and an overview of modern approaches to the treatment of endometrioid ovarian cysts concerning preserving or restoring fertility. The endometrioma influence on the ovarian anatomy and physiology is considered. The comparison of the surgical approach with minimally invasive techniques: aspiration, sclerotherapy of endometrioid cysts is provided. Attention is paid to the effectiveness of assisted reproductive technology in patients after the endometrioma treatment by different methods.