[Ovarian endometriomas: Effect of laparoscopic cystectomy on ovarian response in IVF-ET cycles].
OBJECTIVE
To investigate the follicular response to controlled ovarian hyperstimulation (COH) in IVF-ET cycles after laparoscopic ovarian cystectomy for large endometriomas.


METHODS
In the set of a retrospective controlled study, the medical records of 113 infertile women who underwent IVF-ET cycles after laparoscopic surgery were reviewed. The study group (A) consisted of 63 patients with severe pelvic endometriosis and endometrioma excision. The control group (B) consisted of 50 infertile patients with mild or minimal endometriosis. Interventions were laparoscopic ovarian cystectomy in the study group, and COH in both groups.


RESULTS
Groups A and B were not different in terms of epidemiologic data. The total numbers of recruited follicles (9.1+/-3.3 vs 10.6+/-4.2; P = 0.001), mature follicles (> or =16 mm) (4.2+/-1.7 vs 4.8+/-2.2; P = 0.04), mature oocytes retrieved (5.8+/-3.8 vs 7.4+/-4.6; P = 0.02), and fertilization rate (48.9+/-34.9 vs 61.8+/-32.1%; P = 0.02) observed in group A were lower than those observed in group B, respectively. While the mean number of rFSH ampoules (75 IU) was increased in group A (38.1+/-20.4) compared to group B (29.3+/-16.4; P = 0.004), cumulative pregnancy rates were similar in both groups (27.5+/-8.8% vs 37.2+/-10.6%; P = 0.37).


CONCLUSIONS
Ovarian response was reduced during IVF-ET cycles in patients with history of severe endometriosis and laparoscopic excision of endometriomas compared to women with mild or minimal endometriosis without ovarian surgery.
Yazbeck
C
C
Service de gynécologie-obstétrique et médecine de la reproduction, maternité Aline-de-Crépy, hôpital Bichat-Claude-Bernard, 46, rue Henri-Huchard, 75018 Paris, France. chadi.yazbeck@bch.aphp.fr
Madelenat
P
P
Sifer
C
C
Hazout
A
A
Poncelet
C
C
D000328:Adult; D004624:Embryo Transfer; D004715:Endometriosis / Q000150:complications / Q000601:surgery*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000628:therapy; D010535:Laparoscopy; D010049:Ovarian Diseases / Q000150:complications / Q000601:surgery*; D006080:Ovarian Follicle / Q000503:physiopathology; D010062:Ovulation Induction; D012189:Retrospective Studies; D016896:Treatment Outcome