Ovarian Reserve in Endometriosis: Assessment, Preservation and Reproductive Outcomes

Dear Colleagues,

Endometriosis affects approximately 10% of women of reproductive age and is a leading cause of subfertility and chronic pelvic pain. Ovarian endometrioma, in particular, may be associated with a measurable reduction in ovarian reserve—reflected in lower anti-Müllerian hormone (AMH) concentrations and antral follicle counts—through mechanisms that include local inflammation, oxidative stress, and structural damage to the surrounding healthy ovarian cortex.

Compounding this, the surgical and medical interventions used to treat the disease may themselves further compromise reserve, creating a challenging clinical dilemma. Despite a rapidly expanding evidence base, important questions remain largely unresolved: how best to quantify reserve in affected women, how surgical technique and energy source influence post-operative outcomes, the role of medical suppression and adjunctive therapies, the value of fertility-preservation strategies, and how these decisions translate into natural conception and assisted reproductive technology (ART) success.

This Special Issue aims to present and disseminate the most recent advances in the assessment, preservation, and reproductive implications of ovarian reserve in endometriosis. We welcome original research, systematic reviews, meta-analyses, and expert narrative reviews that advance clinical understanding and inform patient-centred management. Evidence syntheses and methodological studies on ovarian-reserve biomarkers—including their determinants in the broader reproductive-age population—are equally welcome, where they inform care in endometriosis.

Topics of interest for publication include, but are not limited to, the following:

• Biomarkers of ovarian reserve (AMH, antral follicle count, and emerging markers) in endometriosis;
• Impact of ovarian endometrioma characteristics—size, bilaterality, and recurrence—on ovarian reserve;
• Influence of surgical technique (cystectomy versus ablative and energy-based approaches) on post-operative reserve;
• Medical and hormonal management and its effect on ovarian function;
• Fertility-preservation strategies (oocyte, embryo, and ovarian tissue cryopreservation) in women with endometriosis;
• Modifiable, nutritional and endocrine determinants of ovarian reserve and anti-Müllerian hormone (including vitamin D), and their relevance to women with endometriosis;
• Natural conception and ART outcomes following medical or surgical treatment;
• Predictive models and individualised counselling for reproductive decision-making. 

Prof. Dr. Angelos Daniilidis
Guest Editor

Dr. Georgios Grigoriadis
Guest Editor Assistant 

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