The Effect of Surgery for Endometriomas on Fertility

doi:10.1111/1471-0528.14834

Cited by 33 publications

(7 citation statements)

References 40 publications

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“…The endometriotic tissue in OMA may secrete a number of products, including cytokines, chemokines, and growth factors, which may activate specific signaling pathways in the follicular cells, leading to premature follicular development and accelerated atresia ( 9 , 54 ). Some reports suggested that surgical treatment to OMA may improve spontaneous pregnancy rates by restoring the peritoneal anatomy ( 14 , 55 ), and its detrimental effects on ovarian reserve appears to temporary ( 13 ). For patients going into assisted reproductive treatment, the explicit benefits from surgery to pregnancy outcomes in IVF/ICSI are important.…”

Section: Discussionmentioning

confidence: 99%

Analysis of IVF/ICSI-FET Outcomes in Women With Advanced Endometriosis: Influence on Ovarian Response and Oocyte Competence

Zhang

Kuang

et al. 2020

Front. Endocrinol.

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Aims: To determine the impact of advanced endometriosis (EMS) on in vitro fertilization/intracytoplasmic sperm injection and frozen–thawed embryo transfer (IVF/ICSI-FET) outcomes and analyze the influencing factors. Methods: A retrospective study was conducted on sterile women with ovarian endometriomas (OMAs), including patients who underwent laparoscopic cystectomy ( n = 224, 224 IVF/ICSI cycles, 205 FET cycles) and aspiration ( n = 139, 139 IVF/ICSI cycles, 148 FET cycles); peritoneal EMS ( n = 96, 96 IVF/ICSI cycles, 89 FET cycles); and tubal factors ( n = 360, 360 IVF/ICSI cycles, 474 FET cycles). Our main outcomes included the number of MII oocytes retrieved, fertilization rate, the number of viable embryos, viable embryo rate per oocyte retrieved in oocyte retrieval cycles, and clinical pregnancy rate per transfer, live birth rate per transfer, and cumulative clinical pregnancy rate of this oocyte retrieval cycle in FET cycles. Finally, binary logistic regression analysis was performed to generate a prediction model for cumulative clinical pregnancy. Results: The results showed that significantly fewer MII oocytes retrieved and viable embryos and lower viable embryo rate and cumulative clinical pregnancy rate were observed in women with EMS compared with the control. Women with peritoneal EMS had lower fertilization rate and viable embryo rate per oocyte retrieved than patients with OMA (all p < 0.05). However, the pregnancy outcomes were not significantly different between the two phenotypes. The patients who underwent laparoscopic cystectomy had fewer MII oocytes retrieved and viable embryos compared with those with intact endometrioma(s) but no significant difference in pregnancy outcomes between the two types of OMA patients. By binary logistic regression analysis, antral follicle count (AFC) was found to be an independent factor associated with cumulative clinical pregnancy in this oocyte retrieval cycle (odds ratio = 1.054; 95% confidence interval, 1.011–1.100; p = 0.014), and the AFC prediction model of cumulative clinical pregnancy was established, with an area under the curve of 0.60. Conclusions: Our data supported that advanced EMS has negative effect on cumulative clinical pregnancy per oocyte retrieval cycle, and AFC is an independent predictor, which is mainly caused by poor ovarian response associated with OMA per se or its surgery and the damage of peritoneal EMS to oocyte maturation.

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Section: Discussionmentioning

confidence: 99%

Analysis of IVF/ICSI-FET Outcomes in Women With Advanced Endometriosis: Influence on Ovarian Response and Oocyte Competence

Zhang

Kuang

et al. 2020

Front. Endocrinol.

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“…Surgical treatment of endometrioma improves patients' symptoms, such as pain, but the most appropriate approach for reproductive outcomes is still controversial, according to the Royal College of Obstetricians and Gynaecologists (RCOG) [12]. The guidelines from the ESHRE and a Cochrane review state that ovarian cystectomy is the preferred technique in terms of recurrence and spontaneous pregnancy rate after surgery [13,14].…”

Section: Introductionmentioning

confidence: 99%

Impact of Surgical Management of Endometrioma on AMH Levels and Pregnancy Rates: A Review of Recent Literature

Pais

Flagothier

Tebache

et al. 2021

JCM

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Ovarian endometrioma are found in up to 40% of women with endometriosis and 50% of infertile women. The best surgical approach for endometrioma and its impact on pregnancy rates is still controversial. Therefore, we conducted a literature review on surgical management of ovarian endometrioma and its impact on pregnancy rates and ovarian reserve, assessed by anti-Müllerian hormone (AMH) serum levels. Ovarian cystectomy is the preferred technique, as it is associated with lower recurrence and higher spontaneous pregnancy rate. However, ablative approaches and combined techniques are becoming more popular as ovarian reserve is less affected and there are slightly higher pregnancy rates. Preoperative AMH level might be useful to predict the occurrence of pregnancy. In conclusion, AMH should be included in the preoperative evaluation of reproductive aged women with endometriosis. The surgical options for ovarian endometrioma should be individualized. The endometrioma ablation procedure seems to be the most promising treatment.

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“…The increased MPV in patients with endometriomas and BOC can be explained in two ways. First, ovarian cysts apply constant pressure to the ovarian tissue, which causes cells to stretch and atrophy; this leads to the release of inflammatory cytokines and initiates the release of inflammatory mediators, which creates inflammatory conditions in the ovary (14,15). Second, ovarian cysts distort the shape and course of the ovarian arteries, resulting in pressure on the vessels (16).…”

Section: Discussionmentioning

confidence: 99%

Mean Platelet Volume Increase in Endometriomas and Benign Ovarian Cysts: A Prospective Case-Controlled Study

et al. 2021

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Objective: The aim of this research is to compare mean platelet volumes (MPV) among women with ovarian endometriomas, women with benign ovarian cysts and infertile women who were otherwise healthy. Material and Methods: Women were selected for the ovarian endometrioma and benign ovarian cyst group after laparoscopic ovarian cyst excision and confirmed histopathologic evaluation. The control group was assigned from women with male partner infertility or unexplained infertility but who were otherwise healthy. Mean platelet volume calculated as a part of complete blood count, which collected in potassium ethylenediaminetetraacetic acid tubes Results: There were 98 women in the endometrioma group, 94 in the benign cyst group and 99 in the control group. Mean platelet volume was different among the groups (p<0.01). The mean platelet volume in the infertile group was statistically different than in the endometrioma and benign cyst groups and was similar between the endometrioma and benign cyst groups. When compared with the infertile group, the area under the curve and predictive value of the mean platelet volume for the endometrioma and the benign cyst group were 0.73 ±0.03 fl (p<0.01, CI 0.65-0.80) and 0.72±0.06 fl (p<0.01; CI 0.64-0.79), respectively. Mean platelet volume had a sensitivity of 74% and specificity of 63% for endometrioma and sensitivity of 72%, and specificity of 63% for benign cysts at a cut-off point of 9.05 fl. Conclusion: The present study demonstrated that mean platelet volume was increased in women with ovarian endometriomas and benign cysts and showed predictive values for endometriomas and benign ovarian cysts.

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The Effect of Surgery for Endometriomas on Fertility

Cited by 33 publications

References 40 publications

Analysis of IVF/ICSI-FET Outcomes in Women With Advanced Endometriosis: Influence on Ovarian Response and Oocyte Competence

Analysis of IVF/ICSI-FET Outcomes in Women With Advanced Endometriosis: Influence on Ovarian Response and Oocyte Competence

Impact of Surgical Management of Endometrioma on AMH Levels and Pregnancy Rates: A Review of Recent Literature

Mean Platelet Volume Increase in Endometriomas and Benign Ovarian Cysts: A Prospective Case-Controlled Study

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