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. 2008 Jun;25(6):239-44.
doi: 10.1007/s10815-008-9229-y. Epub 2008 Jun 19.

The frequency of ovulation from the affected ovary decreases following laparoscopic cystectomy in infertile women with unilateral endometrioma during a natural cycle

Takashi Horikawa  1 , Koji Nakagawa, Shirei Ohgi, Rieko Kojima, Akira Nakashima, Megumu Ito, Yuji Takahashi, Hidekazu Saito
Affiliations

The frequency of ovulation from the affected ovary decreases following laparoscopic cystectomy in infertile women with unilateral endometrioma during a natural cycle

Takashi Horikawa et al. J Assist Reprod Genet. 2008 Jun.

Abstract

Purpose: To evaluate the cystectomy-induced damage on the follicular growth and ovulation of an affected ovary during natural cycles.

Methods: Twenty-eight infertile patients with unilateral ovarian endometriomas who underwent laparoscopic cystectomy were retrospectively evaluated. The ovulation rate of an affected ovary during natural cycles was compared before and after cystectomy in each patient, and it was also determined if ovulation from the affected ovaries resulted in pregnancy.

Results: After surgery, the ovulation rate was significantly lower than that before cystectomy (16.9 +/- 4.5% vs. 34.4 +/- 6.6%, P = 0.013). After surgery, 14 pregnancies were achieved without IVF treatment, and only 2 of them (14.3%) were achieved from an operated-side ovary. However, the pregnancy rate per ovulatory cycle of the operated-side ovary was not different from that of the intact ovary (8.8% vs. 5.8%, P = 0.750).

Conclusions: Laparoscopic cystectomy is an invasive treatment in that it reduces the frequency of ovulation; however the pregnancy rate per ovulation did not deteriorate.

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Figures

Fig. 1
Fig. 1
Changes of ovulation rates in the affected ovary in each patient. The ovulation rate in the affected ovary before and after laparoscopic cystectomy in each patient was measured. The ovulation rate in the affected ovary after laparoscopic surgery was 16.9 ± 4.5% (mean ± S.E.M.), which was significantly lower than the rate before laparoscopic surgery (34.4 ± 6.6%, P = 0.013). The bars represent the mean ovulation rates. Data were statistically analyzed using the Wilcoxon signed rank test
Fig. 2
Fig. 2
Effects of endometrioma size on ovulation rate. Out of 28 patients, 15 had a relatively small endometrioma (<4 cm in diameter), and, for this group, the ovulation rate after laparoscopic surgery (19.8 ± 6.7%) was significantly lower than the rate before laparoscopic surgery (41.0 ± 8.0%, P = 0.010). On the other hand, for the other 13 patients who had a large endometrioma (≥4 cm in diameter), there was no statistically significant difference in ovulation rates before (26.8 ± 10.9%, P = 0.330) and after laparoscopic surgery (13.5 ± 5.8%). The bars represent the mean of ovulation rates. Data were statistically analyzed using the Wilcoxon signed rank test
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