Outcome of in vitro fertilization/intracytoplasmic sperm injection after laparoscopic cystectomy for endometriomas.
OBJECTIVE
To assess the impact of prior unilateral or bilateral endometrioma cystectomy on controlled ovarian hyperstimulation (COH) and intracytoplasmic sperm injection (ICSI) outcome.


METHODS
Retrospective case-control study.


METHODS
Department of Obstetrics and Gynecology, School of Medicine, Hacettepe University, Ankara, Turkey.


METHODS
Fifty-seven consecutive infertile patients were enrolled who had previously undergone unilateral (n = 34) or bilateral (n = 23) laparoscopic cystectomy for endometriomas more than 3 cm in diameter and underwent ICSI. The control group consisted of 99 patients with tubal factor infertility.


METHODS
Controlled ovarian hyperstimulation and ICSI.


METHODS
Cycle cancellation rate, number of oocytes, fertilization rate, embryo quality, clinical pregnancy rate (PR), and implantation rate.


RESULTS
The mean number of oocytes, metaphase II oocytes, and two-pronucleated oocytes were significantly lower in the bilateral cystectomy group compared to the unilateral cystectomy and control groups. However, all other parameters, including fertilization rate, the mean number of embryos transferred, the mean number of grade 1 embryos transferred, the clinical PR per embryo transfer, and implantation rate, were comparable among the three groups. Within the unilateral cystectomy group, the mean number of oocyte retrieved from the operated site was significantly less than in the contralateral nonoperated site.


CONCLUSIONS
Laparoscopic endometrioma cystectomy does reduce the ovarian reserve. However, diminished ovarian reserve does not translate into impaired pregnancy outcome.
Esinler
Ibrahim
I
Department of Obstetrics and Gynecology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Bozdag
Gurkan
G
Aybar
Funda
F
Bayar
Ulku
U
Yarali
Hakan
H
D000328:Adult; D016022:Case-Control Studies; D015653:Cystectomy / Q000706:statistics & numerical data*; D004715:Endometriosis / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D005307:Fertilization in Vitro / Q000706:statistics & numerical data; D006801:Humans; D007247:Infertility, Female / Q000453:epidemiology* / Q000628:therapy*; D010535:Laparoscopy / Q000706:statistics & numerical data*; D009865:Oocytes / Q000166:cytology; D017063:Outcome Assessment, Health Care; D010051:Ovarian Neoplasms / Q000453:epidemiology / Q000601:surgery*; D010062:Ovulation Induction / Q000706:statistics & numerical data; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D020554:Sperm Injections, Intracytoplasmic / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology