A 29-year-old woman with stage IV endometriosis (ASRM) and bilateral endometriomas undergoes IVF. Her antral follicle count is 6 and AMH is 0.8 ng/mL. Which statement regarding the impact of endometriomas on ovarian reserve and IVF outcomes is correct?
- A Endometriomas directly destroy primordial follicles within the cyst wall
- B Endometriomas must always be drained or excised before IVF
- C The presence of endometriomas is associated with reduced oocyte yield and poorer ovarian response ✓
- D Endometriomas do not affect IVF pregnancy rates but increase miscarriage
Correct answer: C. The presence of endometriomas is associated with reduced oocyte yield and poorer ovarian response
Explanation
Endometriomas are associated with reduced ovarian response during IVF due to mechanical compression, local inflammation, and loss of normal ovarian tissue. Routine cystectomy before IVF is not recommended as it further reduces reserve. Drainage alone has high recurrence. Management depends on size, symptoms, and ovarian reserve.
Reference: ESHRE Guideline: Management of Women with Endometriosis, 2022 ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.