Does laparoscopic cystectomy and cauterization of endometriomas greater than 3 cm diminish ovarian response to controlled ovarian hyperstimulation during IVF‐ET? A case–control study

Abstract

Laparoscopic cystectomy and cauterization for ovarian endometriomas decreases ovarian follicle reserve and does not impede pregnancy rate per cycle during in vitro fertilization and embryo transfer procedure.

The effect of laparoscopic ovarian cystectomy versus coagulation in bilateral endometriomas on ovarian reserve as determined by antral follicle count and ovarian volume: a prospective randomized study

“…In a previous study from our clinic, the IVF results of patients with endometriomas pretreated with laparoscopic cystectomy were compared with age-matched tubal infertility patients. We noted that cystectomy decreased the ovarian follicle reserve but did not reduce the pregnancy rate (34). In our current study, we evaluated the patients who underwent IVF treatment after the surgery for bilateral endometriomas and found that the cystectomized ovaries had statistically significantly fewer dominant follicles and oocytes than the coagulated ovaries.…”

The interovarian variation in three-dimensional ultrasound markers of ovarian reserve in women undergoing baseline investigation for subfertility

“…However, comparison of one ovary with the other may be warranted in situations such as, when examining the effect of pathology or surgery on the ovary. Ovarian cystectomy has been shown to impair ovarian reserve (10)(11)(12)(13)(14) and ovarian response (15)(16)(17)(18)(19)(20)(21) after ART. However, cystectomy and reduced ovarian reserve do not seem to translate into impaired pregnancy outcome (14)(15)(16)(17)22).…”

“…Ovarian cystectomy has been shown to impair ovarian reserve (10)(11)(12)(13)(14) and ovarian response (15)(16)(17)(18)(19)(20)(21) after ART. However, cystectomy and reduced ovarian reserve do not seem to translate into impaired pregnancy outcome (14)(15)(16)(17)22). Data from a few studies suggest that cystectomy might even be detrimental to ovarian response when compared with no surgery (15,(22)(23)(24)(25)(26)(27).…”

National survey of the current management of endometriomas in women undergoing assisted reproductive treatment

“…However, in women undergoing fertility treatment, particularly assisted reproductive treatment (ART), the optimal management of endometriomas is much debated and represents a dilemma to clinicians. Whilst some reproductive specialists believe that endometriomas (.3 cm) should be treated surgically before ART, others argue that surgery could significantly damage ovarian reserve, which could consequently compromise success of treatment (Nargund et al, 1995;Ho et al, 2002;Somigliana et al, 2003Somigliana et al, , 2008Ragni et al, 2005;Esinler et al, 2006;Kahyaoglu et al, 2008;Almog et al, 2010;Benaglia et al, 2010). A systematic review and meta-analysis concluded that surgical treatment of endometriomas before in-vitro fertilisation (IVF) has no effect on ovarian response to stimulation or pregnancy rates compared with no treatment (Tsoumpou et al, 2009).…”