Rate of severe ovarian damage following surgery for endometriomas.
BACKGROUND
There is growing and consistent evidence showing that ovarian reserve is affected following surgical excision of ovarian endometriomas. Of particular concern is the risk of severe ovarian damage leading to unresponsiveness to ovarian hyperstimulation. In this study, we aimed to determine the rate of this complication.


METHODS
Ninety-three women underwent surgery for monolateral endometriomas were recruited. Patients who underwent IVF were selected and, in all cases, follicular growth was monitored by serial transvaginal ultrasonography. The main outcome measure was the rate of ovaries remaining silent when stimulated after surgery for endometriomas.


RESULTS
Absence of follicular growth was observed in 12 operated ovaries although this event never occurred in the contralateral gonad (P < 0.001). The frequency (95% confidence interval) of severe ovarian damage following surgery was 13% (7-21%).


CONCLUSIONS
Severe ovarian damage, occurring in gonads operated on for ovarian endometriomas, is not a rare event.
Benaglia
Laura
L
Infertility Unit, Fondazione Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Via M Fanti 6, 20122 Milan, Italy. laurabenaglia@hotmail.it
Somigliana
Edgardo
E
Vighi
Valentina
V
Ragni
Guido
G
Vercellini
Paolo
P
Fedele
Luigi
L
D000328:Adult; D004715:Endometriosis / Q000601:surgery*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D006080:Ovarian Follicle / Q000503:physiopathology*; D010053:Ovary / Q000601:surgery*; D010062:Ovulation Induction; D011183:Postoperative Complications; D016649:Primary Ovarian Insufficiency / Q000209:etiology; D016896:Treatment Outcome