Does ovarian surgery for endometriomas impair the ovarian response to gonadotropin?

Abstract

Objective: To evaluate the ovarian response to stimulation conducted for IVF treatment in women who have undergone conservative surgery for endometriomas.

Design: Retrospective study with prospective selection of participants and controls.

Setting: University infertility clinic.

Patient(s): A series of 374 women who underwent in vitro fertilization (IVF). The study group consisted of 85 patients with ovarian endometriomas who had undergone laparoscopic surgery in an attempt to become pregnant, but had failed within a year of surgery. The control group consisted of 289 patients with tubal factor infertility.

Intervention(s): IVF-embryo transfer procedures.

Main outcome measure(s): Stimulation parameters, fertilization, implantation, and pregnancy rates were analyzed in both groups.

Result(s): There was no significant difference between the two groups in stimulation parameters or IVF outcome.

Conclusion(s): A total of 820 cycles were analyzed. A similar IVF-ET outcome was observed in patients with endometriosis after ablation of endometriomas compared to women with tubal factors. In conclusion, endometrioma surgery by internal wall vaporization does not impair IVF outcome. The clinical pregnancy rate was respectively 37.4% and 34.6% in the endometriosis group and the control group.