Conservative management versus aspiration of functional ovarian cysts before ovarian stimulation for assisted reproduction.
OBJECTIVE
To compare the efficiency of transvaginal ultrasound-guided functional ovarian cyst aspiration, with conservative management, in the outcome of patients undergoing assisted reproductive technique (ART) (in vitro fertilization or intracytoplasmic sperm injection). These cysts were identified before ovarian stimulation begun and after administration of a midluteal GnRH agonist.


METHODS
Fifty nine patients undergoing ART from January 1, 1997 to February 28, 1999, who developed functional ovarian cysts were included. Aspirations of these cysts (n = 14) versus conservative management (observation) (n = 45) were compared. Total number of ovarian follicles developed, number of oocytes retrieved, estradiol levels on the day of human chorionic gonadotropin, fertilization rate, number of good quality embryos transferred, implantation, and clinical pregnancy rate per cycle were evaluated.


RESULTS
No statistical differences were observed between the two groups in any of the selected parameters.


CONCLUSIONS
Cyst aspiration and conservative management showed similar implantation and pregnancy rates, in patients who develop functional ovarian cysts after pituitary down-regulation following luteal phase gonadotropin-releasing hormone agonist administration. Prospective studies are needed to confirm this trend.
Fiszbajn
G E
GE
Centro de Estudios en Ginecología y Reproducción, Buenos Aires, Argentina.
Lipowicz
R G
RG
Elberger
L
L
Grabia
A
A
Papier
S D
SD
Brugo Olmedo
S P
SP
Chillik
C F
CF
D000328:Adult; D006063:Chorionic Gonadotropin / Q000097:blood; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D007987:Gonadotropin-Releasing Hormone / Q000009:adverse effects / Q000031:analogs & derivatives / Q000494:pharmacology; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D009865:Oocytes / Q000187:drug effects / Q000378:metabolism; D010048:Ovarian Cysts / Q000601:surgery* / Q000628:therapy*; D006080:Ovarian Follicle / Q000187:drug effects / Q000473:pathology / Q000601:surgery; D010053:Ovary / Q000187:drug effects / Q000473:pathology* / Q000601:surgery; D010062:Ovulation Induction; D020554:Sperm Injections, Intracytoplasmic
D006063:Chorionic Gonadotropin; D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol; D007986:Luteinizing Hormone