Surgical management of endometriosis

Holoch, K.; Shenoy, Chandra; Falcone, Tommaso

doi:10.1586/17474108.2013.825474

Cited by 1 publication

(2 citation statements)

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“…Most involve opening and draining the cyst followed by either excision using the stripping technique or ablation of the cyst wall with electrocautery or CO 2 laser. 17 Due to a high recurrence rate, drainage alone is not recommended. 17 A Cochrane review found that excisional surgery provides better outcomes than ablative surgery.…”

Section: Discussionmentioning

confidence: 99%

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Pregnancy Outcomes After Endometrioma Excision in Patients Undergoing In Vitro Fertilization and Embryo Transfer: A Historical Cohort Study

RajuRubin

AgarwalKomal

AbuzeidOmar

et al. 2015

Journal of Gynecologic Surgery

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Objective: The objective of the study was to examine the effect of endometrioma excision on pregnancy outcomes in women with advanced-stage endometriosis who underwent in vitro fertilization and embryo transfer (IVF-ET). Design: This is a historical cohort study. Materials and Methods: We compared the pregnancy outcomes of 141 women undergoing IVF-ET. The study group consisted of 25 patients who had stage III/IV endometriosis and endometrioma excision (group 1). The control groups included 40 patients who had stage III/ IV endometriosis, but no endometrioma and who underwent ovariolysis (group 2) and 76 patients with tubal factors infertility who underwent tubal surgery (group 3). After surgery up to two IVF-ET cycles in each group were analyzed. Results: Our study showed that the mean total dose of gonadotropin administered in IVF-ET cycle I was higher in group 1 compared with groups 2 and 3 ( p = 0.03). Otherwise, there was no significant difference in the ovarian responses among the three groups. There was a statistically significant increase in clinical pregnancy rate per cycle in the endometrioma group (69.7%) versus the ovariolysis group (48.1%) and tubal factor group (48.0%). However, there was no significant difference in delivery rate per cycle among the three groups. There was a statistically significant higher miscarriage rate in the endometrioma group (39.1%) compared with the ovariolysis group (11.5%) and tubal factor group (14.3%). Conclusion: In conclusion, our study suggests that endometrioma excision surgery does not compromise the overall ovarian reserve or pregnancy outcomes after IVF-ET.

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Section: Discussionmentioning

confidence: 99%

“…17 Due to a high recurrence rate, drainage alone is not recommended. 17 A Cochrane review found that excisional surgery provides better outcomes than ablative surgery. 18 Donnez et al (2010) described a combined technique using both excision and ablation to minimize ovary damage and recurrence rates.…”

Section: Discussionmentioning

confidence: 99%