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

Abstract

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.

Aspiration and ethanol sclerotherapy to treat recurrent ovarian endometriomas prior to in vitro fertilization – a pilot study

“…However, there is evidence that extensive surgeries or repeat surgeries may damage ovarian reserves (22)(23)(24)(25)(26) , compromising the success of a subsequent IVF (27) . The ovulation rate has repeatedly been shown to be decreased in post-surgical gonads compared to intact gonads (24,28) . In cycles of IVF/ICSI, there was a decreased response to controlled ovarian stimulation in the ovaries that underwent the operation (23,25) .…”

“…In cycles of IVF/ICSI, there was a decreased response to controlled ovarian stimulation in the ovaries that underwent the operation (23,25) . In addition, the presence of the endometrioma itself may negatively influence ovarian function (16,24) in addition to impeding oocyte aspiration during IVF/ICSI treatment (16) . There are several likely advantages of treating endometriomas by puncture and sclerotherapy in comparison to conventional treatments with resection by video laparoscopy, mainly when there is a recurrence.…”

The interovarian variation in three-dimensional ultrasound markers of ovarian reserve in women undergoing baseline investigation for subfertility

“…This might be due to the inadvertent removal of normal ovarian tissue along with the cyst or damage caused by the use of diathermy. Some studies have used ultrasound measures including ovarian volume, AFC, and blood flow (10,13,28) to compare the operated ovary to the unoperated contralateral ovary. Other studies have evaluated the effect of surgery by comparing the ovarian response to controlled ovarian stimulation during ART in the operated ovary to the contralateral normal ovary (13,14,16,19,23,28).…”

Ovarian Endometrioma and Infertility

“…Other studies have shown that the spontaneous ovulation rate is significantly lower in the affected ovary [20,21] . A dose-response effect was observed; when only one endometrioma was present the ovulation rate in the affected ovary was 35%, but when an ovary contained two or more cysts, the ovulation rate was only 19% [22] .…”