title: Recurrent endometrioma and ovarian reserve: biological connection or surgical paradox?
abstract: OBJECTIVE
  Cumulative evidence supports the view that ovarian endometriomas originate from ovulatory events and that the ovarian reserve is reduced following surgery. On these bases, we have hypothesized that the risk of recurrence may be related to the residual ovarian reserve of the operated ovary.
  
  
  METHODS
  We retrospectively selected 45 women scheduled for in vitro fertilization who previously underwent surgical excision of monolateral endometriomas and compared ovarian responsiveness in those who did (n = 24) and did not (n = 21) have a recurrent endometrioma.
  
  
  RESULTS
  In the intact ovaries, the mean ± SD number of codominant follicles in women with and without recurrences was 3.5 ± 1.7 and 3.7 ± 2.2, respectively (P = NS). In the affected ovaries, the mean ± SD number of follicles in gonads with and without recurrences was 2.5 ± 2.3 and 1.1 ± 1.5, respectively (P < .05).
  
  
  CONCLUSIONS
  Ovarian responsiveness is higher in gonads that developed recurrent endometriomas.
authors.affiliation: Department of Obstetrics, Gynecology, and Neonatology, Fondazione Instituto di Ricovero e Cura a Carattere Scientifico Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy. dadosomigliana@yahoo.it
authors.forename: Edgardo
authors.initials: E
authors.lastname: Somigliana
authors.forename: Laura
authors.initials: L
authors.lastname: Benaglia
authors.forename: Paolo
authors.initials: P
authors.lastname: Vercellini
authors.forename: Alessio
authors.initials: A
authors.lastname: Paffoni
authors.forename: Guido
authors.initials: G
authors.lastname: Ragni
authors.forename: Luigi
authors.initials: L
authors.lastname: Fedele
mesh_terms: D000328:Adult; D004715:Endometriosis / Q000453:epidemiology* / Q000601:surgery*; D005260:Female; D006801:Humans; D010049:Ovarian Diseases / Q000453:epidemiology* / Q000601:surgery*; D010060:Ovulation; D012008:Recurrence; D012189:Retrospective Studies