Personalized Reproductive Management After Surgical Treatment of Ovarian Endometriosis

Ovarian endometriosis is a chronic, estrogen-dependent gynecological disorder that significantly impairs reproductive function and is a leading cause of infertility in women of reproductive age. Surgical management, particularly laparoscopic cystectomy, is widely used to remove endometriotic lesions and improve fertility outcomes. However, postoperative reproductive success is highly variable and cannot be explained by surgical intervention alone, which highlights the necessity of a personalized reproductive management approach. This study analyzes current evidence on fertility outcomes following surgical treatment of ovarian endometriosis and emphasizes individualized strategies for optimizing reproductive success. Literature indicates that postoperative fertility outcomes depend on multiple factors, including patient age, ovarian reserve (AMH and AFC levels), disease severity, cyst characteristics, and duration of infertility. Although surgery may improve spontaneous conception by restoring pelvic anatomy and reducing inflammatory processes, it may also lead to a decline in ovarian reserve due to inadvertent damage to healthy ovarian tissue. Therefore, integrating assisted reproductive technologies (ART), particularly in vitro fertilization (IVF), plays a crucial role in patients with diminished ovarian reserve or delayed conception. Additionally, fertility preservation strategies such as oocyte and embryo cryopreservation further enhance reproductive potential in high-risk cases.