Does Endometriosis Affect Fertility?
Endometriosis refers to the growth of endometrial tissue outside the uterine cavity. When it grows on the ovary, it is commonly known as a chocolate cyst, or endometrioma.
What many people worry about most is:
“Will it affect my ovarian function or eggs?”
“Will it make it harder for me to get pregnant?”
Dr. Li has summarized the latest research for everyone.
Does ovarian endometriosis affect ovarian reserve?
• Studies have found that patients with chocolate cysts tend to have lower AMH, which reflects ovarian reserve, compared with women of the same age.
• AMH also tends to decline faster, suggesting that the ovaries may show signs of “aging” earlier than expected.
• AFC, the number of small follicles seen on ultrasound, may also be lower. However, AFC is not as sensitive as AMH, and sometimes the cyst may block the view, making it harder to assess clearly.
Therefore, chocolate cysts may cause the ovaries to “age earlier,” especially as reflected by AMH levels.
Does it affect the ovarian response to medication, eggs, and embryos?
• During IVF treatment, the number of retrieved eggs is usually lower.
• The number of usable embryos and good-quality embryos may also be slightly reduced.
• Most studies show that the effect on egg “quality” is not significant. The main impact is the reduced “quantity” of eggs.
In other words, chocolate cysts affect egg quantity more than egg quality.
Does it affect pregnancy rates and live birth rates?
Although ovarian reserve and the number of retrieved eggs may decrease, studies show that clinical pregnancy rates and live birth rates are not significantly worse.
As long as enough eggs can be retrieved, the final chance of pregnancy is usually not greatly affected, even with chocolate cysts.
In other words, chocolate cysts may increase the “difficulty” of the fertility process, but they do not necessarily determine whether pregnancy is possible.
Dr. Li’s summary:
Chocolate cysts mainly affect egg “quantity” and ovarian reserve, with AMH showing a more obvious decline.
The effect on egg quality is limited.
If enough eggs can still be retrieved, pregnancy rates and live birth rates are usually not significantly affected.
Yun-I wishes your dreams come true!
