MODERN APPROACHES TO THE ASSESSMENT AND PRESERVATION OF REPRODUCTIVE POTENTIAL IN WOMEN WITH OVARIAN ENDOMETRIOMAS

Ovarian endometriomas, a common manifestation of Endometriosis, are closely associated with impaired reproductive function and infertility in women of reproductive age. This study aimed to evaluate modern approaches to the assessment and preservation of reproductive potential in women diagnosed with ovarian endometriomas. A prospective cohort study was conducted involving 120 women aged 18–40 years, divided into three groups based on management strategy: conservative treatment, surgical intervention, and assisted reproductive technology, including In Vitro Fertilization (IVF).Reproductive potential was assessed using biochemical markers such as anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), and estradiol levels, along with ultrasound parameters including antral follicle count (AFC) and ovarian volume. Clinical outcomes such as pregnancy rates, time to conception, and miscarriage rates were evaluated over a 12-month follow-up period. The results demonstrated that surgical management was associated with a significant decline in ovarian reserve markers, while conservative management preserved ovarian function but resulted in longer time to conception. The IVF group showed the highest clinical pregnancy rates and the shortest time to conception, with stable ovarian reserve parameters. A significant correlation was found between AMH levels and reproductive outcomes. In conclusion, individualized management strategies are essential for optimizing reproductive outcomes in women with ovarian endometriomas. Assisted reproductive technologies appear to be the most effective approach for achieving pregnancy, while conservative management may be preferable for preserving ovarian reserve in selected patients.