Impact of ovarian endometrioma on assisted reproduction outcomes.
The effects of ovarian endometrioma on fertility outcomes with IVF and embryo transfer have been causally related to poor outcomes. The objective of this meta-analysis was to evaluate the ovarian reserve and ovarian responsiveness to ovarian stimulation and assisted reproduction outcomes in patients with ovarian endometrioma. The odds for clinical pregnancy were not affected significantly in patients with ovarian endometrioma compared with controls, with an overall odds ratio of 1.07 from three studies [95% CI: (0.63, 1.81), P = 0.79]. The overall pregnancy rate was similar with an estimated odds ratio of 1.17 [95% CI: (0.85, 1.60), P = 0.34]. Decreased ovarian responsiveness to ovarian stimulation in patients with ovarian endometrioma may be due to a reduced number of follicles in these patients compared with controls (P = 0.002). Prospective randomized controlled trials are needed to assess whether surgical treatment versus no surgical treatment improves pregnancy outcomes in patients with ovarian endometrioma undergoing assisted reproduction cycles.
Gupta
Sajal
S
Reproductive Research Centre, Glickman Urological Institute and the Department of Obstetrics-Gynecology, Cleveland Clinic Foundation, Cleveland, OH, USA. guptas2@ccf.org
Agarwal
Ashok
A
Agarwal
Rishi
R
Loret de Mola
J Ricardo
JR
D004715:Endometriosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007247:Infertility, Female / Q000209:etiology*; D018587:Oocyte Donation; D010049:Ovarian Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy; D006080:Ovarian Follicle / Q000473:pathology; D011247:Pregnancy; D011256:Pregnancy Outcome; D027724:Reproductive Techniques, Assisted; D015983:Selection Bias; D020554:Sperm Injections, Intracytoplasmic; D014463:Ultrasonography