Impact of laparoscopic cystectomy on fecundity of infertility patients with ovarian endometrioma.
OBJECTIVE
To clarify the effect of laparoscopic cystectomy for ovarian endometrioma in infertility patients, the pregnancy outcome was evaluated.


METHODS
This was a retrospective study. From August 2002 to February 2006, 33 infertility patients with ovarian endometrioma underwent laparoscopic cystectomy at our center. According to the laparoscopic findings 33 were divided into two groups; 10 were evaluated as the patients who need assisted reproductive technologies (ART) treatment (IVF subgroup) and 23 were evaluated as the patients who do not need ART treatment but conventional infertility treatment (non-IVF subgroup). During the same period, 70 patients who were age-matched and received ART treatment without laparoscopy were defined as control (control group). Following up to 12 months after laparoscopy, the cumulative pregnancy rate in the non-IVF subgroup was calculated.


RESULTS
The patients age, duration of infertility and size of endometrioma were equal in the IVF and the non-IVF subgroups. The revised-American Society of Reproductive Medicine (r-ASRM) score in the IVF subgroup was significantly higher than that in the non-IVF group (P < 0.05). The pregnancy rates after laparoscopic cystectomy in IVF and non-IVF subgroups were 50.0% and 60.9%, respectively. These rates in the IVF and the non-IVF groups were slightly higher than that in control group (41.4%), but these differences were not significant. The cumulative pregnancy rate in the non-IVF group reached 52.2%, 12 months after laparoscopic surgery.


CONCLUSIONS
Laparoscopic surgery should be performed prior to ART treatment not only for making a decision about the treatment course but also for establishing a good pelvic condition to induce a pregnancy during ART treatment in infertility treatment with ovarian endometrioma.
Nakagawa
Koji
K
Division of Reproductive Medicine, Department of Perinatal Medicine and Maternal Care, National Center for Child Health and Development, Tokyo, Japan. nakagawa-kj@ncchd.go.jp
Ohgi
Shirei
S
Kojima
Rieko
R
Sugawara
Kana
K
Ito
Megumu
M
Horikawa
Takashi
T
Irahara
Minoru
M
Saito
Hidekazu
H
D000328:Adult; D015653:Cystectomy / Q000379:methods; D004715:Endometriosis / Q000601:surgery*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007247:Infertility, Female / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods; D010049:Ovarian Diseases / Q000601:surgery*; D011247:Pregnancy; D012189:Retrospective Studies