Is there an Indication for Fertility Preservation in Infertile Women with Endometriosis? How-Why-When?

Women with endometriosis are at risk of compromised ovarian reserve because of the pathogenesis of their disease but also due to the iatrogenic negative contribution of a surgical treatment. Fertility preservation in women with endometriosis is a real issue and should be taken under concern especially in cases of women with age >35, with low ovarian reserve, bilateral endometriomas, recurrent surgical interventions, or even for all women with stage III and IV of disease. From February 2020 to August 2020 the authors systematically reviewed relevant literature that evaluates the possible benefits of fertility preservation in women with endometriosis. 68 articles were screened and 20 articles were finally included in our study. During the last decade oocyte vitrification, has permitted indeed major advances in the field of assisted reproductive technology. Cryopreservation of oocytes is the consolidated fertility preservation technique providing long term autonomy to women affected by endometriosis giving them a valid treatment option to enhance their reproductive chances. Specific robust data on fertility preservation in women with endometriosis, consensus on the strategy to adopt and cost-effectiveness studies are still lacking in the literature. The need of individualized approach taking into account age, ovarian reserve prior and planned surgical interventions is more than obvious. Counseling regarding fertility preservation by oocyte vitrification could be a first line approach for infertile women suffering from endometriosis.