{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T01:50:53Z","timestamp":1791856253553,"version":"4.3.4"},"reference-count":91,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T00:00:00Z","timestamp":1742515200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Ovarian endometriomas (OEMs), cystic formations within the ovaries, are a significant manifestation of endometriosis and present in 20\u201340% of affected women. Despite extensive research, the pathogenesis of endometriosis remains unclear, with retrograde menstruation, coelomic metaplasia, and lymphatic dissemination being proposed mechanisms. OEMs negatively impact ovarian function by reducing the ovarian reserve, disrupting folliculogenesis, and altering the ovarian microenvironment through oxidative stress, inflammation, and fibrosis. Elevated reactive oxygen species (ROS) accelerate follicular atresia, and extracellular matrix remodeling contributes to ovarian damage, while immune dysregulation and cytokine imbalances further exacerbate the condition. The presence of OEMs does not significantly affect live birth rates in in vitro fertilization (IVF) treatments, despite potential reductions in the quality and quantity of oocytes. However, their surgical excision compromises the ovarian reserve. This review highlights the complex mechanisms by which OEMs impair ovarian function and emphasizes the need for further research to develop strategies that mitigate these effects, ultimately improving reproductive outcomes for women with endometriomas.<\/jats:p>","DOI":"10.3390\/jcm14072147","type":"journal-article","created":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T09:09:07Z","timestamp":1742548147000},"page":"2147","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Mechanisms of Endometrioma-Mediated Ovarian Damage: Myths and Facts"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0306-6422","authenticated-orcid":false,"given":"P\u0131nar","family":"\u00d6zcan","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Uskudar University School of Medicine, 34768 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0941-2314","authenticated-orcid":false,"given":"Bulut","family":"Varl\u0131","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Ankara University School of Medicine, 06620 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ertan","family":"Sar\u0131do\u011fan","sequence":"additional","affiliation":[{"name":"Women\u2019s Health Division, University College London Hospital, London WC1E 6BT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Engin","family":"Oral","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Biruni University School of Medicine, 34015 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammed","family":"Mabrouk","sequence":"additional","affiliation":[{"name":"Women\u2019s Health Division, University College London Hospital, London WC1E 6BT, UK"},{"name":"Cleveland Clinic London Hospital, London SW1X 7HY, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taner","family":"Usta","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Acibadem University, Altunizade Hospital, 34662 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0210-2660","authenticated-orcid":false,"given":"Alin Stefan","family":"Constantin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Saarland University Hospital, 66421 Hamburg, Germany"},{"name":"Department of Obstetrics and Gynecology, Carol Davila\u2019 University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1016\/j.fertnstert.2012.07.1125","article-title":"Endometriosis: Enigmatic in the pathogenesis and controversial in its therapy","volume":"98","author":"Donnez","year":"2012","journal-title":"Fertil. 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