title: Outcome of in vitro fertilization and ovarian response after endometrioma stripping at laparoscopy and laparotomy.
abstract: 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
authors.affiliation: Department of Obstetrics and Gynecology, Gulhane Military Medical Academy (GATA) School of Medicine, Ankara, Turkey. nkduru@gata.edu.tr
authors.forename: Namik Kemal
authors.initials: NK
authors.lastname: Duru
authors.forename: Murat
authors.initials: M
authors.lastname: Dede
authors.forename: Cengiz Han
authors.initials: CH
authors.lastname: Acikel
authors.forename: Ugur
authors.initials: U
authors.lastname: Keskin
authors.forename: Ulas
authors.initials: U
authors.lastname: Fidan
authors.forename: Iskender
authors.initials: I
authors.lastname: Baser
mesh_terms: 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
chemical_list: D005300:Fertility Agents, Female; D005640:Follicle Stimulating Hormone