Damage to ovarian reserve associated with laparoscopic excision of endometriomas: a quantitative rather than a qualitative injury.
OBJECTIVE
Retrospective studies suggest that laparoscopic excision of endometriomas is associated with a reduced responsiveness to ovarian hyperstimulation. In this study, we prospectively evaluated ovarian response to hyperstimulation in women selected for in vitro fertilization and intracytoplasmic sperm injection cycles who previously underwent laparoscopic enucleation of a monolateral endometrioma.


METHODS
Operated and contralateral intact ovaries of the same patient were compared in terms of number of follicles, number of oocytes retrieved, fertilization rate, and rate of high-quality embryos.


RESULTS
Thirty-eight subjects were included. A reduced number of dominant follicles, oocytes, embryos, and high-quality embryos was observed in the operated gonad. The mean percentage of reduction was 60% (95% confidence interval 38-81%), 53% (95% confidence interval 30-75%), 55% (95% confidence interval 28-81%), and 52% (95% confidence interval 17-87%), respectively. Fertilization rate and rate of good-quality embryos were similar.


CONCLUSIONS
Laparoscopic excision of endometriomas is associated with a quantitative but not a qualitative damage to ovarian reserve.
Ragni
Guido
G
Infertility Unit, Policlinico, Mangiagalli and Regina Elena Hospital, Università Degli Studi di Milano, Milan, Italy.
Somigliana
Edgardo
E
Benedetti
Francesca
F
Paffoni
Alessio
A
Vegetti
Walter
W
Restelli
Liliana
L
Crosignani
Pier Giorgio
PG
D000328:Adult; D004624:Embryo Transfer; D004715:Endometriosis / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects; D006801:Humans; D010535:Laparoscopy; D009865:Oocytes; D010048:Ovarian Cysts / Q000503:physiopathology / Q000601:surgery*; D006080:Ovarian Follicle; D010053:Ovary / Q000000981:diagnostic imaging / Q000187:drug effects / Q000293:injuries / Q000503:physiopathology*; D010062:Ovulation Induction; D011184:Postoperative Period; D011446:Prospective Studies; D014463:Ultrasonography