Outcome of in vitro fertilization and ovarian response after endometrioma stripping at laparoscopy and laparotomy.
OBJECTIVE
To add further data on in vitro fertilization (IVF) outcome and ovarian response after endometrioma stripping via either laparoscopy or laparotomy.


METHODS
IVF outcome and ovarian response parameters in patients who had undergone unilateral endometrioma stripping at laparoscopy (n=28) or laparotomy (n=10) before IVF were retrospectively compared.


RESULTS
Fertilization rates, number of embryos transferred and pregnancy rates did not differ between the groups. Significantly more recombinant FSH was used to induce folliculogenesis, and fewer metaphase II oocytes were retrieved in the laparotomy group. The laparotomy-postcystectomy ovaries were significantly smaller and malpositioned. In both stripping groups, significantly smaller operated-on ovaries with lower numbers of antral and mature follicles were observed as compared to intact ovaries.


CONCLUSIONS
A higher amount of FSH is needed to achieve an acceptable IVF outcome after unilateral endometrioma surgery. Indications for surgical treatment of patients having larger and bilateral cysts with an expectation for future fertility should be cautiously reviewed
Duru
Namik Kemal
NK
Department of Obstetrics and Gynecology, Gulhane Military Medical Academy (GATA) School of Medicine, Ankara, Turkey. nkduru@gata.edu.tr
Dede
Murat
M
Acikel
Cengiz Han
CH
Keskin
Ugur
U
Fidan
Ulas
U
Baser
Iskender
I
D000328:Adult; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D004715:Endometriosis / Q000150:complications / Q000601:surgery*; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage*; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D010048:Ovarian Cysts / Q000150:complications* / Q000601:surgery; D010053:Ovary / Q000187:drug effects* / Q000473:pathology / Q000601:surgery; D010062:Ovulation Induction / Q000379:methods*; D012189:Retrospective Studies
D005300:Fertility Agents, Female; D005640:Follicle Stimulating Hormone