Laparoscopic ovarian cystectomy of endometriomas does not affect the ovarian response to gonadotropin stimulation

Marconi, Guillermo; Vilela, M.; Quintana, Ramiro; Sueldo, Carlos

doi:10.1016/s0015-0282(02)03326-5

Cited by 106 publications

(58 citation statements)

References 14 publications

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“…Canis et al (18) and Marconi et al (19) found no effect on ovarian response in IVF after cystectomy. But, there are many other trials that indicate that cystectomy has a bad influence in the subsequent ovarian responsiveness.…”

Section: Total Cystectomymentioning

confidence: 95%

Ovarian cystectomy in endometriomas: Combined approach

Ünlü

Yıldırım

2014

J Turkish German Gynecol Assoc

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Endometrioma is one of the most frequent adnexal masses in the premenopausal population, but the recommended treatment is still a subject of debate. Medical therapy is inefficient and can not be recommended in the management of ovarian endometriomas. The general consensus is that ovarian endometriomas larger than 4 cm should be removed, both to reduce pain and to improve spontaneous conception rates. The removal of ovarian endometriomas can be difficult, as the capsule is often densely adherent. While the surgical treatment of choice is surgical laparoscopy, for conservative treatment, the preferred method is modified combined cystectomy. Cystectomy can be destructive for the ovary, whereas ablation may be incomplete, with a greater risk of recurrence. To the best of our knowledge, the modified combined technique seems to be more efficient in the treatment of endometriomas. (J Turk Ger Gynecol Assoc 2014; 15: 177-89) Key words: Endometrioma, laparoscopy, cystectomy, combined technique Received: 25 August, 2014 Accepted: 29 August, 2014 Ovarian cystectomy in endometriomas: Combined approach This article will be credited by TMA within the scope of CME/CPD.

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Section: Total Cystectomymentioning

confidence: 95%

Ovarian cystectomy in endometriomas: Combined approach

Ünlü

Yıldırım

2014

J Turkish German Gynecol Assoc

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“…Recent evidence suggests that laparoscopic cystectomy of an ovarian endometrioma reduces ovarian reserve and consequently the response to ovarian stimulation [12,[15][16][17][18]. Most of these reports compared the adverse effects of cystectomy on subsequent response to IVF treatments, such as the response to controlled ovarian hyperstimulation and the mean number of oocytes retrieved in operated versus non-operated patients [21,[27][28][29], but there were few A large endometrioma (≥4 cm in diameter) Fig.…”

Section: Discussionmentioning

confidence: 99%

“…Cystectomy is commonly performed on endometriomas more than 3 cm in diameter before ART treatment [12]. Some studies reported that endometrioma cystectomy had no detrimental effect on controlled ovarian hyperstimula-tion or on ART outcomes [13,14], while some other studies reported that endometrioma cystectomy reduced response to controlled ovarian hyperstimulation [15][16][17][18]. The authors report that reduced ovarian response and decreased ovarian reserve after cystectomy was directly affected by the surgery [15][16][17].…”

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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“…17 Canis et al and Marconi et al found no effect on ovarian response in IVF after cystectomy. 18,19 But, there are many other trials that indicate that cystectomy has a bad influence in the subsequent ovarian responsiveness. As Hart et al concluded, excisional surgery of endometriomas results in a more favorable outcome than drainage and ablation in terms of recurrence, pain symptoms, subsequent spontaneous pregnancy in previously sub-fertile women, and ovarian response to stimulation.…”

Section: Fenestration and Ablation (Fulguration Or Vaporization)mentioning

confidence: 99%

A review article on ovarian cystectomy in endometriomas by laparoscopy

Yadav

Patel

2017

Int J Reprod Contracept Obstet Gynecol

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Endometrioma is one of the most frequent adnexal masses in the reproductive population. Medical therapy is inefficient and cannot be recommended in the management of ovarian endometriomas. The general consensus is that ovarian endometriomas larger than 4 cm should be removed, both to reduce pain and to improve spontaneous conception rates. The removal of ovarian endometriomas can be difficult, as the capsule is often densely adherent. While the surgical treatment of choice is surgical laparoscopy, for conservative treatment, the preferred method is modified combined cystectomy. Cystectomy can be destructive for the ovary, whereas ablation may be incomplete, with a greater risk of recurrence.

show abstract

Laparoscopic ovarian cystectomy of endometriomas does not affect the ovarian response to gonadotropin stimulation

Cited by 106 publications

References 14 publications

Ovarian cystectomy in endometriomas: Combined approach

Ovarian cystectomy in endometriomas: Combined approach

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

A review article on ovarian cystectomy in endometriomas by laparoscopy

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