title: Rate of severe ovarian damage following surgery for endometriomas.
abstract: 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.
authors.affiliation: Infertility Unit, Fondazione Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Via M Fanti 6, 20122 Milan, Italy. laurabenaglia@hotmail.it
authors.forename: Laura
authors.initials: L
authors.lastname: Benaglia
authors.forename: Edgardo
authors.initials: E
authors.lastname: Somigliana
authors.forename: Valentina
authors.initials: V
authors.lastname: Vighi
authors.forename: Guido
authors.initials: G
authors.lastname: Ragni
authors.forename: Paolo
authors.initials: P
authors.lastname: Vercellini
authors.forename: Luigi
authors.initials: L
authors.lastname: Fedele
mesh_terms: 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