{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T04:11:39Z","timestamp":1783397499040,"version":"3.54.6"},"reference-count":25,"publisher":"S. Karger AG","issue":"5","license":[{"start":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T00:00:00Z","timestamp":1739404800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T00:00:00Z","timestamp":1739404800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gynecol Obstet Invest"],"abstract":"<jats:p>Objectives: The aim of the study was to evaluate current practices among gynecologists in managing large endometriomas before in vitro fertilization (IVF). Design: A cross-sectional online survey was conducted. Participants\/Materials: The survey was distributed to an estimated 410 gynecologists, with 111 specialists completing the survey (response rate: 27.8%). Among respondents, 73% practiced in academic settings, and 61% had more than 15 years of clinical experience. Setting: Gynecologists involved in IVF treatments or endometrioma surgery were recruited via email through professional societies across multiple countries. Methods: An online survey consisting of 18 questions covering clinical experience, surgical thresholds, techniques, hormonal protocols, and timing of ovarian stimulation post-surgery was distributed through professional societies. Responses were collected anonymously and analyzed using SPSS version 29.0.2.0. Results: Laparoscopic cystectomy was the most common procedure (48.2%). The median threshold size for surgery was 50 mm (interquartile range [IQR] 40\u201360). Despite the same median threshold, surgeons performing laparoscopic surgery as their main clinical activity had a significantly different distribution of thresholds (IQR 40\u201360 vs. 47\u201389, p = 0.006), with a tendency to recommend surgery for smaller endometriomas. Techniques like CO&lt;sub&gt;2&lt;\/sub&gt; laser ablation and plasma energy were less commonly used. Notably, 40.5% of participants indicated they would change their practice if a CO&lt;sub&gt;2&lt;\/sub&gt; laser or plasma energy device were available in their surgical armamentarium. Most participants (67.9%) adjusted their strategy based on preoperative anti-M\u00fcllerian hormone levels. The average timing for IVF stimulation post-surgery was 6 weeks (IQR 4\u20138) with no difference across different experiences. Limitations: The survey-based design may introduce response bias and reflect only the opinions of those who chose to participate. Additionally, the study may not capture regional or institutional differences comprehensively. Conclusion: Managing large endometriomas before IVF involves balancing surgical benefits with risks to ovarian reserve. The survey highlights significant variability in practices, with a median surgical threshold size of 50 mm. Laparoscopic cystectomy, while common, is associated with ovarian tissue loss, whereas emerging techniques like CO&lt;sub&gt;2&lt;\/sub&gt; laser ablation show promise in preserving ovarian reserve. The need for up-to-date evidence-based guidelines is essential to standardize practices and optimize outcomes for IVF patients. <\/jats:p>","DOI":"10.1159\/000543673","type":"journal-article","created":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T12:02:56Z","timestamp":1739448176000},"page":"453-461","source":"Crossref","is-referenced-by-count":1,"title":["When and How Is Surgery Required for Large Endometrioma prior to in vitro Fertilization: A Survey of Practices"],"prefix":"10.1159","volume":"90","author":[{"given":"Jonas Jean Mathieu","family":"Vibert","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milena","family":"Alec","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1543-2802","authenticated-orcid":false,"given":"Antonio Simone","family":"Lagan\u00e0","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Benagiano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Pluchino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2025,2,13]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.5468\/ogs.2019.62.1.1"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.3390\/medicina59091643"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2020.03.003"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1093\/hropen\/hoac009"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogoh.2018.06.003"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2017.04.003"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2022.08.097"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/det123"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2022.08.860"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7827-9-80"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deu354"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2010.04.023"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2011.07.675"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.18502\/ijrm.v13i11.7960"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2011.05.078"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1093\/hropen\/hoaa012"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2014.04.019"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2010.11.038"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.23736\/S2724-606X.22.05188-0"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2011.04.068"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2019.07.027"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2022.12.014"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD005999.pub2"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1177\/17455057241252573"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2024.102500"}],"container-title":["Gynecologic and Obstetric Investigation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/goi\/article-pdf\/doi\/10.1159\/000543673\/4338641\/000543673.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000543673","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T16:04:43Z","timestamp":1759766683000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000543673"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,13]]},"references-count":25,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,10,6]]},"published-print":{"date-parts":[[2025,10,8]]}},"URL":"https:\/\/doi.org\/10.1159\/000543673","archive":["Portico"],"relation":{},"ISSN":["0378-7346","1423-002X"],"issn-type":[{"value":"0378-7346","type":"print"},{"value":"1423-002X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,13]]}}}