Laparoscopic removal of endometriomas: sonographic evaluation of residual functioning ovarian tissue

Exacoustòs, C.; Zupi, Errico; Amadio, A.; Szabolcs, B.; Vivo, B De; Marconi, Daniela; Romanini, M. E.; Arduini, Domenico

doi:10.1016/j.ajog.2004.01.010

Cited by 91 publications

(25 citation statements)

References 22 publications

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“…We hypothesized that an inverse relation could be found between the morphologic characteristics of the removed ovarian tissue adjacent to the excised cyst during surgery and endometrioma recurrence; however, we failed to find this correlation. Several authors have reported that laparoscopic excision of endometriomas results in excessive removal of ovarian tissue containing follicles compared with cystectomy of other types of benign ovarian tumors . However, there were differing reports regarding the association between the size of endometrioma and the amount of ovarian tissue removed during cystectomy .…”

Section: Discussionmentioning

confidence: 99%

Clinicopathologic risk factors for recurrence of ovarian endometrioma following laparoscopic cystectomy

Sengoku

Miyamoto

Horikawa

et al. 2013

Acta Obstet Gynecol Scand

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Section: Discussionmentioning

confidence: 99%

Clinicopathologic risk factors for recurrence of ovarian endometrioma following laparoscopic cystectomy

Sengoku

Miyamoto

Horikawa

et al. 2013

Acta Obstet Gynecol Scand

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“…In fact, operated patients who later underwent ovarian stimulation for IVF showed increased resistance to hormonal stimulation and obtained less oocytes at retrieval (Busacca et al, 2006;Matalliotakis et al, 2007;Ragni et al, 2005). Some authors reported that after laparoscopic cystectomy of benign ovarian cysts (including endometriomas) the volume and the AFC of the operated ovary are both significantly lower than those of the contralateral ovary (Candiani et al, 2005;Exacoustos et al, 2004;Somigliana et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic stripping of endometriomas negatively affects ovarian follicular reserve even if performed by experienced surgeons

Biacchiardi¹,

Piane

Camanni³

et al. 2011

Reproductive BioMedicine Online

138

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In order to estimate the impact of laparoscopic stripping of endometriomas on the ovarian follicular reserve, 43 normo-ovulatory women were studied by endocrine (anti-Müllerian hormone (AMH), FSH, LH, inhibin B, oestradiol) and ultrasonographic (antral follicle count (AFC)) methods before surgery, and 3 and 9 months after surgery. The operation was performed by experienced laparoscopists, particularly aware of the need to avoid damaging the healthy part of the ovary. Serum AMH concentrations significantly decreased after the operation (1.4±0.2 ng/ml after 3 months and 1.3±0.3 ng/ml after 9 months versus 3.0±0.4 ng/ml before surgery; P<0.0001), whereas basal FSH, LH, oestradiol and inhibin B concentrations remained unchanged. The volume of the operated ovary significantly diminished after surgery (P<0.0001), whereas the AFC was not significantly altered. Overall, the data show that laparoscopic stripping of endometriomas reduces ovarian reserve. The significant decrease of AMH after surgery confirms that part of the healthy ovarian pericapsular tissue, containing primordial and preantral follicles, is removed or damaged despite all the surgical efforts to be atraumatic. This must be carefully considered when laparoscopic cystectomy surgery is scheduled for patients with no relevant symptoms besides infertility or with already small ovarian reserve.

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“…Surgical treatment of endometrioma may further worsen the ovarian reserve and responsiveness to gonadotrophin (Gn) 10 by inadvertently removing healthy ovarian tissue 11 or compromising the vascular supply of the ovary. 12 A newly published systematic review and meta-analysis also showed that women with endometriosis have a lower oocyte yield and a lower fertilisation rate than women with tubalfactor infertility. However, once the oocyte is fertilised, the embryo has a normal chance of implantation, leading to similar pregnancy rates.…”

Section: Introductionmentioning

confidence: 99%

Endometriosis has no negative impact on outcomes of in vitro fertilisation in women with poor ovarian response

Yang

Huang

Cai

et al. 2016

BJOG

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Objective To compare the in vitro fertilisation (IVF) outcomes of poor ovarian responders among women with laparoscopically diagnosed minimal-mild endometriosis (Group A), moderate-severe endometriosis (Group B) and those without endometriosis (Group C). The comparisons were made separately for age groups younger than 35 years and 35 years or older.Design Retrospective study.Setting A university-affiliated hospital in Guangzhou, China.Population 495 women younger than 35 years old and 543 women aged 35 or older who had poor ovarian response with or without laparoscopically diagnosed endometriosis.Methods Poor ovarian response (POR) was diagnosed using the Bologna criteria. First cycle parameters were analysed over the same period of time from January 2011 to October 2014.Main outcome measures The primary endpoint was the live birth rate per embryo transfer cycle. Secondary outcome measures were clinical pregnancy rate, cycle cancellation rate and miscarriage rate.Results In women aged 35 or older no differences were found among the three subgroups in terms of live birth rate, clinical pregnancy rate, cycle cancellation rate or miscarriage rate; in women aged younger than 35 years, the clinical pregnancy rates were 62.96, 45.45 and 43.27% for Groups A, B and C, respectively (P = 0.028). The live birth rate, cycle cancellation rate and miscarriage rate were not significantly different. Compared with the older group of women, the younger women had a significantly higher live birth rate (P < 0.001).Conclusions A woman's age is the most important factor governing the live birth rate with IVF. Endometriosis has no consistent impact on IVF outcomes in women with POR.Keywords Aging, assisted reproductive technology outcome, endometriosis, poor ovarian reserve, poor ovarian responder.Tweetable abstract Endometriosis has no negative impact on IVF outcomes in women with poor ovarian response.

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Laparoscopic removal of endometriomas: sonographic evaluation of residual functioning ovarian tissue

Cited by 91 publications

References 22 publications

Clinicopathologic risk factors for recurrence of ovarian endometrioma following laparoscopic cystectomy

Clinicopathologic risk factors for recurrence of ovarian endometrioma following laparoscopic cystectomy

Laparoscopic stripping of endometriomas negatively affects ovarian follicular reserve even if performed by experienced surgeons

Endometriosis has no negative impact on outcomes of in vitro fertilisation in women with poor ovarian response

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