Ovarian response after laparoscopic ovarian cystectomy for endometriotic cysts in 132 monitored cycles

Abstract

Objective: To investigate the follicular response of ovaries after laparoscopic ovarian cystectomy for endometriotic cysts.

Design: A retrospective, controlled study.

Setting: Obstetrics and Gynaecology Department of a university hospital.

Patient(s): Patients with history of infertility who had laparoscopic ovarian cystectomy for endometriotic cysts.

Intervention(s): Laparoscopic ovarian cystectomy, transvaginal ultrasound monitoring of follicles in natural cycles, stimulated cycles using clomiphene citrate (CC), chronic low-dose FSH, and "flare down" regimen.

Main outcome measure(s): Follicular response of postcystectomy and normal ovaries.

Result(s): For women < 35 years of age, the mean follicular response of postcystectomy ovaries was reduced significantly when compared with normal ovaries in natural cycles (0.30 versus 1.00 follicle per cycle) and in CC-stimulated cycles (0.87 versus 1.27 follicles per cycle). The mean follicular response was not statistically significantly different when the ovaries were stimulated with chronic low-dose FSH or with the flare down regimen. For women > or = 35 years, postcystectomy ovaries responded with a comparable number of follicles as the normal ovaries in natural cycles and the three different ovarian stimulation regimens.

Conclusion(s): Postcystectomy ovaries showed reduced follicular response in natural and CC-stimulated cycles for women < 35 years of age. Postcystectomy ovaries produced a comparable number of follicles as normal ovaries when stimulated with gonadotropins.