Endometriosis and Ovarian Reserve

Clinical Evidence and Presentation

The American College of Radiology reports that endometriosis affects at least one-third of women with infertility and up to 10% of reproductive-aged women 1
Women with endometriosis may present with reduced ovarian reserve markers, including decreased antral follicle counts 2
Ovarian volume <3 cm³ and <5 antral follicles present are indicators of diminished ovarian reserve in women with endometriosis 1

Transvaginal ultrasound (TVUS) can be used to monitor follicle development, perform antral follicle counts, and measure ovarian volume to assess ovarian reserve 1
MRI can detect endometriomas with high sensitivity (82-90%) and specificity (91-98%) when TVUS findings are indeterminate 2
Laparoscopy remains the standard for both diagnosis and staging of endometriosis, especially for detecting small endometrial implants not well visualized on imaging 1

Up to 44% of women experience symptom recurrence within one year after surgery for endometriosis, potentially leading to progressive ovarian damage 3