Impact of large ovarian endometriomas on the response to superovulation for in vitro fertilization: A retrospective study. (June 2017)

• Record Type: Journal Article
• Authors: Ferrero, Simone; Scala, Carolina; Tafi, Emanuela; Racca, Annalisa; Venturini, Pier Luigi; Leone Roberti Maggiore, Umberto
• Is Part Of: European journal of obstetrics, gynecology, and reproductive biology. Volume 213(2017)
• Page Start: 17
• Page End: 21
• Publication Date: 2017-06
• Subjects: Endometriomas -- ICSI -- in vitro fertilization -- Oocyte -- Pregnancy; Obstetrics -- Periodicals; Gynecology -- Periodicals; Reproductive health -- Periodicals; Gynecology -- Periodicals; Obstetrics -- Periodicals; Reproduction -- Periodicals; Obstétrique -- Périodiques; Gynécologie -- Périodiques; Reproduction -- Périodiques; Verloskunde; Gynaecologie; Voortplanting (biologie); Gynecology; Obstetrics; Reproduction; Electronic journals; Periodicals; Electronic journals; 618.05
• DOI: 10.1016/j.ejogrb.2017.04.003
• Languages: English
• ISSNs: 0301-2115

Abstract

Abstract: Objective: To assess the response to superovulation for in vitro fertilization (IVF) in patients with unilateral endometriomas with diameter ≥5 cm and in the contralateral healthy ovary. Study design: This retrospective analysis of a prospectively collected database included patients who underwent superovulation for IVF/ICSI cycles and had unoperated single unilateral endometrioma with diameter ≥5 cm and healthy contralateral ovary. The primary outcome of the study was to compare the number of oocyte retrieved in the ovary with the endometrioma and the contralateral healthy ovary. Results: The total number of follicles was lower in ovaries with endometriomas (2.6 ± 1.3) than in healthy ovaries (4.8 ± 2.0; p < 0.001). The number of codominant follicles and the total number of oocytes retrieved were lower in ovaries with endometriomas (1.5 ± 0.9 and 2.0 ± 1.2) than in the contralateral ovaries (3.7 ± 1.5 and 4.2 ± 1.7; p < 0.001, respectively). The number of oocytes retrieved suitable for fertilization was lower in ovaries with endometriomas (1.5 ± 1.1) than in the healthy ovaries (3.3 ± 1.5; p < 0.001). The total number of oocytes retrieved and the number of oocytes retrieved suitable for fertilization were lower in ovaries with endometriomas respectively in 21 (80.8%) and in 20 (76.9%) cases. The decreased responsiveness to ovarian superovulation was confirmed considering women with ultrasonographic diagnosis of deep infiltrating endometriosis. 30.8% of patients had positive HCG; the pregnancy rate was 23.1%. Conclusion: The presence of large endometriomas (≥5 cm) at time of IVF significantly decreases the number of oocyte retrieved compared with the contralateral healthy ovaries.