Impact of laparoscopic cystectomy on fecundity of infertility patients with ovarian endometrioma

Nakagawa, Koji; Ohgi, Shirei; Kojima, Ryosuke; Sugawara, K.; Ito, Megumu; Horikawa, Takashi; Irahara, Minoru; Saito, Hidekazu

doi:10.1111/j.1447-0756.2007.00630.x

Cited by 31 publications

(22 citation statements)

References 31 publications

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“…Nakagawa et al [4] expressed major concern about the loss of follicles associated with the stripping procedure. But in both the randomized control studies of Beretta et al [6], Alborzi et al [7] and Hye et al [8] the spontaneous pregnancy was significantly greater in the excision group 66.7% vs 23.5%, 59.3%vs 23.3% and 38.9% vs 11.1% (Table 4).…”

Section: Discussionmentioning

confidence: 99%

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A Study of Fertility Outcome and Recurrence between Laparoscopic Enucleation and Fulgration of Endometriotic cyst wall

Ray¹

2015

Int Jour of Biomed Res

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Objectives: The objective of this study is to determine the most effective technique for treating an ovarian endometrioma between the laparoscopic enucleation of endometrioma by stripping of the cyst wall and drainage and fulgration of the cyst wall. Methods: We retrospectively studied 52 infertile women who underwent endometriotic cyst enucleation by stripping of the cyst wall (Group 1) or drainage and fulgration of the cyst wall (Group 2) in AV Hospital during January 2010 and December 2011. They were studied for 18 months after their laparoscopic surgery to determine the effectiveness of the surgery for fertility outcome and recurrence of the cyst. Results: The overall pregnancy rate for the two groups under study was 46% (24/52).While 63% (21/33) of Group 1 conceived either spontaneously or through Artificial Reproductive Technique (ART), only 15%(3/19) of Group 2 conceived spontaneously. Further, the pregnancy rate for the stage IV patients was relatively low 7% (4/52) compared to the stage III patients 38.46% (20/52). Additionally, 21%(4/19)of the patients of Group 2 had recurrence of pregnancy as compared to 6%(2/33) of the patients of Group 1. Conclusions: Laparoscopic enucleation by stripping method of the endometrioma results in higher rate of pregnancy either spontaneously or by ART. Further, this method also results in reduced risk of recurrence of the endometrioma and reduced rate of further surgery.

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Section: Discussionmentioning

confidence: 99%

“…Nakagawa et al [4] state that the presence of endometriosis is thought to reduce fecundity, therefore cystectomy is commonly performed for endometriomas more than 3 cm in diameter before ART treatment.…”

Section: Discussionmentioning

confidence: 99%

A Study of Fertility Outcome and Recurrence between Laparoscopic Enucleation and Fulgration of Endometriotic cyst wall

Ray¹

2015

Int Jour of Biomed Res

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“…Since an ovarian endometrioma itself reduces fecundity in infertile patients, the removal of it might be an optimal treatment. Indeed, our recent report indicated that laparoscopic removal of an ovarian endometrioma had significant benefits for infertile patients, including an improved pregnancy outcome [19].…”

Section: Discussionmentioning

confidence: 99%

“…Most recently we reported that removal of endometriomas improved fecundity [19], and another report showed that, despite a reduction in ovarian reserve following laparoscopic cystectomy, pregnancy rate was unaffected [20]. In women who underwent unilateral cystectomy, the mean number of oocytes retrieved from the operated ovary was significantly less than that obtained from the contralateral, non-operated-ovary [21].…”

Section: Introductionmentioning

confidence: 99%

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

Horikawa

Nakagawa

Ohgi

et al. 2008

J Assist Reprod Genet

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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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“…Although there is a consensus that operative laparoscopy should be considered the first line treatment in symptomatic women with endometriomas [3,4], there is ongoing debate on how to manage endometriomas before attempting assisted reproductive technology (ART) treatment. Some investigators have indicated that ovarian surgery might improve the fecundity of infertility patients with ovarian endometriomas [5,6]. However, others have not reported improvements in pregnancy rate following surgical treatment in the context of ART [7].…”

Section: Introductionmentioning

confidence: 99%

Poor pregnancy outcome following assisted reproductive technology among women operated on for bilateral endometriomas

Yamamoto

Umeki

Maeda

et al. 2009

Reprod Medicine & Biology

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Purpose To determine the first line of infertility treatment for managing patients with unilateral or bilateral ovarian endometriomas. Methods We evaluated pregnancy outcome in patients who had received ovarian surgery for unilateral (Group U, n = 47) or bilateral endometriomas (Group B, n = 38) and aspiration with or without alcohol fixation for unilateral (Group u, n = 37) or bilateral endometriomas (Group b, n = 22). Subsequently, 64 of these women, excluding 29 dropouts, underwent assisted reproductive technology. We compared the clinical pregnancy rates of the four groups. Results The cumulative pregnancy rate after operation of Group B (18%) was significantly lower than that of a cystfree control group (n = 143; 44%) and Group U (43%). Group B had fewer oocytes fertilized during ART than did Group b (P \ 0.005) and fewer blastocysts available for transfer (P \ 0.005). The cumulative pregnancy rate of Group B was also lower than in Group b (P = 0.052). Conclusions Pregnancy outcomes of Group B were not better than for Group b. Therefore, encouraging such women to move directly to ART might help avoid ovarian damage and improve their ability to achieve a pregnancy.

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Impact of laparoscopic cystectomy on fecundity of infertility patients with ovarian endometrioma

Abstract: Laparoscopic surgery should be performed prior to ART treatment not only for making a decision about the treatment course but also for establishing a good pelvic condition to induce a pregnancy during ART treatment in infertility treatment with ovarian endometrioma.

Cited by 31 publications

References 31 publications

A Study of Fertility Outcome and Recurrence between Laparoscopic Enucleation and Fulgration of Endometriotic cyst wall

A Study of Fertility Outcome and Recurrence between Laparoscopic Enucleation and Fulgration of Endometriotic cyst wall

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

Poor pregnancy outcome following assisted reproductive technology among women operated on for bilateral endometriomas

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