Deep posterior endometriosis surgery and ovarian reserve

Impact of Surgery for Deep Posterior Endometriosis on Ovarian Reserve

This trial will test whether surgery for severe deep posterior endometriosis changes ovarian reserve in women aged 18 to 39 who do not have ovarian endometriomas.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 100 (estimated)
• Ages: 18 Years to 39 Years
• Sex: Female
• Sponsor: Ramsay Générale de Santé (Academic / other)
• Locations: 1 site (Quint-Fonsegrives)
• Trial ID: NCT07469007 on ClinicalTrials.gov

What this trial studies

Women aged 18–39 with suspected or confirmed severe deep posterior pelvic endometriosis and no ovarian endometriomas will undergo planned surgical resection. Ovarian reserve will be measured before and after surgery using anti‑Müllerian hormone (AMH) assays and pelvic ultrasound including antral follicle count, and participants will complete symptom and reproductive history questionnaires. The study excludes patients with prior surgery for severe deep endometriosis, significant preoperative ovarian insufficiency, recent GnRH agonist use, BMI >35, or menopause. The trial is conducted at Clinique la croix du sud in Quint‑Fonsegrives and is sponsored by Ramsay Générale de Santé.

Who should consider this trial

Good fit: Ideal candidates are women 18–39 with imaging or laparoscopic confirmation of severe deep posterior endometriosis, no endometrioma >5 mm, eligible for surgery, and covered by social security.

Not a fit: Patients with ovarian endometriomas, prior surgery for severe deep endometriosis, severe low ovarian reserve (AMH <1 ng/mL and AFC <8), menopausal women, or those with BMI >35 are unlikely to benefit from this protocol.

Why it matters

Potential benefit: If successful, results could help doctors and patients understand fertility risks of surgery and improve counseling and surgical planning.

How similar studies have performed: While ovarian reserve loss after cystectomy is well documented, the specific impact of surgery for severe deep posterior endometriosis without ovarian involvement has not been previously studied.

Eligibility criteria

Inclusion Criteria:

* Female, aged 18 to 39 years old;
* Suspected severe deep posterior pelvic endometriosis on reference pelvic MRI (ovarian kissing, obliteration of the pouch of Douglas) with concordant clinical examination, or confirmed severe deep posterior pelvic endometriosis during exploratory laparoscopy;
* Patient affiliated with or covered by a social security plan;
* Patient having been informed and having given her free, informed, and written consent

Exclusion Criteria:

* Presence of ovarian involvement defined by the presence of at least one endometrioma \>5 mm;
* History of surgery for severe deep endometriosis;
* Severe preoperative premature ovarian insufficiency (defined by AMH \<1ng/mL and antral follicle count \<8);
* Concurrent use of GnRH agonist therapy at or within the preceding 3 months of enrollment;
* BMI \>35 kg/m²;
* Menopausal status;
* Patient participating in another trial with an exclusion period that has not yet expired at the time of screening;
* Protected patient: adult under guardianship, curatorship, or other legal protection, deprived of liberty by judicial or administrative decision;
* Pregnant, breastfeeding, or postpartum woman.

Where this trial is running

Quint-Fonsegrives

• Clinique la croix du sud — Quint-Fonsegrives, France (Recruiting)

Study contacts

• Study coordinator: Jean-François Oudet

Conditions Endometriosis; Ovarian Reserve