title: Effects of previous ovarian surgery on the follicular response to ovulation induction in an in vitro fertilization program.
abstract: This study examined the effects of previous ovarian surgery on the clinical response to ovulation induction with clomiphene citrate-human menopausal gonadotropin in an in vitro fertilization program. Patients were divided into five clinical groups: group A (n = 63), no previous ovarian surgery; B (n = 9), unilateral cystectomy; C (n = 6), unilateral oophorectomy with no contralateral ovarian surgery; D (n = 7), bilateral ovarian surgery with both ovaries present; and E (n = 4), unilateral oophorectomy and contralateral cystectomy. Patients in group E demonstrated significantly lower serum estradiol on cycle days 9-11 (P less than or equal to .05) and fewer follicles on cycle days 11-12 (P less than or equal to .05) than did patients in groups A-D. The percentage of cancelled cycles increased with increasing amounts of ovarian surgery (P less than or equal to .03). The study suggests that one cause of a poor response to ovulation induction for in vitro fertilization may be prior extensive ovarian surgery.
authors.affiliation: Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA 02115.
authors.forename: M D
authors.initials: MD
authors.lastname: Hornstein
authors.forename: R L
authors.initials: RL
authors.lastname: Barbieri
authors.forename: P M
authors.initials: PM
authors.lastname: McShane
mesh_terms: D000328:Adult; D002996:Clomiphene / Q000627:therapeutic use; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D005498:Follicular Phase; D006801:Humans; D008596:Menotropins / Q000627:therapeutic use; D010053:Ovary / Q000601:surgery*; D010062:Ovulation Induction / Q000379:methods*; D013514:Surgical Procedures, Operative / Q000009:adverse effects*
chemical_list: D002996:Clomiphene; D004958:Estradiol; D008596:Menotropins