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Meta-Analysis
. 2018 Apr;297(4):1043-1057.
doi: 10.1007/s00404-017-4640-1. Epub 2018 Jan 17.

The effect of surgical management of endometrioma on the IVF/ICSI outcomes when compared with no treatment? A systematic review and meta-analysis

M Nickkho-Amiry  1 , R Savant  2 , K Majumder  2 , E Edi-O'sagie  2 , M Akhtar  2
Affiliations
Meta-Analysis

The effect of surgical management of endometrioma on the IVF/ICSI outcomes when compared with no treatment? A systematic review and meta-analysis

M Nickkho-Amiry et al. Arch Gynecol Obstet. 2018 Apr.

Abstract

Objective: To assess the impact of surgical management of endometrioma on the outcome of assisted reproduction treatment (ART).

Design: A systematic review and meta-analysis.

Setting: Department of reproductive medicine at teaching university hospital, UK.

Patients: Subfertile women with endometrioma undergoing ART.

Interventions: Surgical removal of endometrioma or expectant management.

Main outcome measures: Clinical pregnancy rate, pregnancy rate, live birth rate, number of oocytes retrieved and number of embryos available and ovarian response to gonadotrophins.

Results: An extensive search of electronic databases for articles published from inception to September 2016 yielded 11 eligible studies for meta-analysis. Meta-analysis was conducted comparing surgery versus no treatment of endometrioma. There were no significant differences in pregnancy rate per cycle, clinical pregnancy rate and live birth rate between women who underwent surgery for endometrioma and those who did not.

Conclusion: Current evidence suggests that women with endometriosis-related infertility have similar cycle outcomes to other patients going through ART. It is pertinent for clinicians to assess the risks of surgical intervention on ovarian reserve prior to initiating therapy.

Keywords: ART; Endometrioma; Pregnancy outcome; Surgery.

PubMed Disclaimer

Conflict of interest statement

Funding

No funding was needed for this work.

Conflict of interest

There are no conflicts of interest.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

Figures

Fig. 1
Fig. 1
Prisma flow diagram
Fig. 2
Fig. 2
Forest plots examining outcome measures. a Surgical treatment versus no treatment (10 studies). 1. Live birth rate/cycle. 2. Clinical pregnancy/cycle. 3. Pregnancy/cycle. 4. Estradiol peak (pg/ml). 5. Total oocytes retrieved/cycle (continuous data). 6. Total no. of embryos created/cycle. 7. Gonadotrophins ampoules/cycle. 8. Gonadotrophins total dose/cycle. b Surgical treatment versus aspiration (4 studies). 1. Pregnancy/cycle. 2. Clinical pregnancy/cycle
Fig. 2
Fig. 2
Forest plots examining outcome measures. a Surgical treatment versus no treatment (10 studies). 1. Live birth rate/cycle. 2. Clinical pregnancy/cycle. 3. Pregnancy/cycle. 4. Estradiol peak (pg/ml). 5. Total oocytes retrieved/cycle (continuous data). 6. Total no. of embryos created/cycle. 7. Gonadotrophins ampoules/cycle. 8. Gonadotrophins total dose/cycle. b Surgical treatment versus aspiration (4 studies). 1. Pregnancy/cycle. 2. Clinical pregnancy/cycle
See this image and copyright information in PMC

Comment in

  • Letter to the editor.
    Laursen JB, Schroll JB. Laursen JB, et al. Arch Gynecol Obstet. 2019 Jan;299(1):287. doi: 10.1007/s00404-018-4984-1. Epub 2018 Dec 7. Arch Gynecol Obstet. 2019. PMID: 30523441 No abstract available.
  • Reply to letter to the editor.
    Nickkho-Amiry M. Nickkho-Amiry M. Arch Gynecol Obstet. 2019 Jan;299(1):289-291. doi: 10.1007/s00404-018-4992-1. Epub 2018 Dec 7. Arch Gynecol Obstet. 2019. PMID: 30536116 No abstract available.

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