The effect of surgical treatment for endometrioma on in vitro fertilization outcomes: a systematic review and meta-analysis

Tsoumpou, Ioanna; Kyrgiou, Maria; Gelbaya, Tarek A.; Nardo, Luciano G.

doi:10.1016/j.fertnstert.2008.05.049

Cited by 183 publications

(119 citation statements)

References 71 publications

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“…The management of endometriomas that are <40 mm in size in women who attempt to conceive remains a matter of debate 5, 13, 14, 15. The results of this study demonstrated that the AFC, the number of follicular flushings, the number of retrieved oocytes, and the number of obtained embryos were all significantly lower for the endometrioma‐containing ovary than for the contralateral, intact ovary.…”

Section: Discussionmentioning

confidence: 71%

Pregnancy outcomes after assisted reproductive procedures with embryos that had been derived from affected and unaffected ovaries among women with small unilateral endometriomas

Takashima

Takeshita

Kinoshita

2017

Reprod Medicine & Biology

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AimTo clarify the effects of small endometriomas on in vitro fertilization (IVF) outcomes. In the present study, the potential impact of small ovarian endometriomas on the quantitative and qualitative outcomes of IVF was evaluated in the same individual.MethodsA retrospective analysis was performed, in which 118 infertile women with unilateral endometriomas that were <40 mm in size and who underwent IVF or intracytoplasmic sperm injection were evaluated. Single frozen embryo transfer cycles were performed, with separate data collections for both the affected and the unaffected ovaries, which allowed for an evaluation of the implantation rate.ResultsThe mean antral follicular count and the number of follicular flushings, retrieved oocytes, and obtained embryos were significantly lower for the endometrioma‐containing ovary than for the contralateral, intact ovary. No significant difference was observed regarding the blastocyst retrieval and good‐quality blastocyst retrieval rates, pregnancy rate, and clinical pregnancy or live birth rate.ConclusionAlthough the patients with a small endometrioma had a decreased ovarian reserve, they had lower pregnancy rates. The decision to transfer an embryo from an endometrioma‐containing ovary or from a contralateral, intact ovary also might not influence the pregnancy rate.

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Section: Discussionmentioning

confidence: 71%

Pregnancy outcomes after assisted reproductive procedures with embryos that had been derived from affected and unaffected ovaries among women with small unilateral endometriomas

Takashima

Takeshita

Kinoshita

2017

Reprod Medicine & Biology

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“…The clinical impact of this effect appears to be marginal as the same study showed a similar pregnancy rate after IVF between these patients and women with tubal factor fertility [22]. More recently, a study of 99 infertile couples randomized women to surgical excision of endometriomas prior to IVF-ICSI or immediate IVF-ICSI with the endometrioma aspirated at the time of oocyte collection.…”

Section: In Vitro Fertilizationmentioning

confidence: 99%

“…Moreover, such large endometriomas may restrict vaginal access to the ovary during retrieval. So, while ovarian cystectomy for an endometrioma should not be routine before IVF, it may be appropriate in selected cases of larger cysts [3,22]. In patients with history of previous surgery for endometriomas, or with reduced ovarian reserve, drainage of endometriomas prior to IVF may be an alternative to cystectomy to improve accessibility of ovarian follicles.…”

Section: In Vitro Fertilizationmentioning

confidence: 99%

Treatment of Endometriosis in Women Desiring Fertility

Mavrelos

Sarıdoğan

2015

J Obstet Gynecol India

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Endometriosis is a common condition affecting a significant proportion of women in their reproductive age. Apart from the impact of endometriosis on the quality of life of these patients, it also can have an impact on the potential of these women to have a family. The options for treating women with endometriosis desiring a family include surgery or assisted reproduction techniques. The choice of treatment will depend on the stage of disease and the characteristics of the couple seeking help. We review here the latest evidence on the management of endometriosis in women desiring fertility and describe our current practice.

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“…Furthermore, they pointed that removing endometrioma did not affect the quality of oocyte in IVF cycle as an evidence of no additional advantage of surgery in ART cycle [27]. On the other hand, some investigators did not support the same opinion [28][29][30][31]. It is clear that considerable surgical expertise is requied to decrease ovarian damage and avoid incomplete surgery [32].…”

Section: Management Of Infertilitymentioning

confidence: 99%

Management of Endometriosis-Associated Infertility

2014

J Androl Gynaecol

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Endometriosis is a common, chronic disease. Patients typically present with pelvic pain, infertility, and/or an adnexal mass. Results from the limited number of studies that have been published indicate that the true prevalence of endometriosis, along with the associated infertility, has been increasing. Debates about infertility management arise from the contradiction between the contraceptive nature of medical treatments for endometriosis and the unpredictable ovarian reserve after surgery. There is moderate quality evidence that surgery increases clinical pregnancy rate and live birth in minimal to mild endometriosis. However, insufficient evidences which supports the effect of surgery in moderate to severe endometriosis in term of subfertility. On this basis, artificial reproductive technologies have been become the most efficient way of overcoming endometriosisassociated infertility, particularly in stage III/IV endometriosis. The objective of this paper is to review recent trends in endometriosis, from the pathophysiology of the disease to the management of infertility.endometriosis and infertility and to assess the current approaches and management modalities used for infertile women with endometriosis. PathophysiologyAs previously mentioned, how endometriosis contributes to infertility remains controversial. However, there are a few hypotheses that describe the pathophysiology of endometriosis-associated infertility when the endometriotic lesion is located in the pelvic cavity, ovary, or uterus [8]. Distorted Pelvic AnatomyPelvic adhesions that develop as a consequence of endometriosis can interfere with ovulation, transport of the oocyte or ovum, and pick-up by the fimbriae. The oviducts may be patent bilaterally, but existing adhesions around the adnexa can interrupt the dynamic movements of the fimbriae that are necessary for oocyte uptake [9]. Altered Peritoneal MilieuThe chronic inflammatory status of the pelvic cavity in endometriosis patients has been recognized for decades. This inflammation is accompanied by increased infiltration of macrophages in the pelvic fluid. The pathophysiology has not been well-described, but increased recruitment of immune cells and dysregulated apoptosis of endometrial cells present in the lesion are thought to be contributing factors. Additional support for this hypothesis arises from the observation that in addition to the macrophages, inflammatory cytokines, and prostaglandins, chemokines stimulate and aggregate monocytes and granulocytes. RANTES [10], monocyte inflammatory protein-1 [11,12] IntroductionEndometriosis is a disease characterized by ectopic endometrial glands and stromal tissue external to the uterine cavity. The prevalence of the disease has been reported to be 5-10% in women of reproductive age, 20-30% in women diagnosed with infertility, and 40-60% in women with chronic pelvic pain [1]. Fecundity, the probability of giving live birth in a menstrual cycle, has been shown to be 0.02-0.1 per month in women with endometriosis, but is 0.15-0.2 ...

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The effect of surgical treatment for endometrioma on in vitro fertilization outcomes: a systematic review and meta-analysis

Cited by 183 publications

References 71 publications

Pregnancy outcomes after assisted reproductive procedures with embryos that had been derived from affected and unaffected ovaries among women with small unilateral endometriomas

Pregnancy outcomes after assisted reproductive procedures with embryos that had been derived from affected and unaffected ovaries among women with small unilateral endometriomas

Treatment of Endometriosis in Women Desiring Fertility

Management of Endometriosis-Associated Infertility

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