title: Unoperated ovarian endometriomas and responsiveness to hyperstimulation.
abstract: BACKGROUND
  There is a growing consensus that ovarian reserve is reduced after surgical excision of ovarian endometriomas. However, it remains to be fully clarified whether this damage precedes or follows surgery. In order to further elucidate this aspect, we evaluated ovarian responsiveness to hyperstimulation in women selected for IVF with unilateral unoperated endometriomas. The main aim of this study was to compare the number of developing follicles in the affected ovary with that in the contralateral intact gonad as a control.
  
  
  METHODS
  Patients selected for IVF who were diagnosed with one or more monolateral endometriomas (diameter <4 cm) and who did not undergo previous ovarian surgery were retrospectively identified. We compared the number of follicles (diameter ≥ 11 mm) and the number of co-dominant follicles (diameter >15 mm) on the day of hCG administration in the affected and intact ovaries.
  
  
  RESULTS
  Among the 84 women selected, the median interquartile range (IQR) number of follicles ≥ 11 mm in the affected and intact ovaries was 5 (3-7) and 5 (3-8), respectively (P= 0.36). The median (IQR) number of co-dominant follicles in the affected and intact ovaries was 3 (2-4) and 3 (2-5), respectively (P= 0.48). The number of co-dominant follicles was lower in the affected ovary in 36 cases (43%, 95% confidence interval: 32-53%). We also failed to identify any statistically significant difference between the two ovaries when evaluating data according to the number of cysts, their dimension, the dose of gonadotrophins used or the number of oocytes retrieved.
  
  
  CONCLUSIONS
  In women selected for IVF, the presence of an endometrioma does not markedly affect responsiveness to hyperstimulation.
authors.affiliation: Department of Obstetrics, Gynecology and Neonatology , Fondazione Cà Granda, Ospedale Maggiore Policlinico, Via M. Fanti, 6, 20122 Milan, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Benaglia
authors.forename: Roberta
authors.initials: R
authors.lastname: Pasin
authors.forename: Edgardo
authors.initials: E
authors.lastname: Somigliana
authors.forename: Paolo
authors.initials: P
authors.lastname: Vercellini
authors.forename: Guido
authors.initials: G
authors.lastname: Ragni
authors.forename: Luigi
authors.initials: L
authors.lastname: Fedele
mesh_terms: D000328:Adult; D004715:Endometriosis / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D006801:Humans; D010049:Ovarian Diseases / Q000601:surgery; D006080:Ovarian Follicle / Q000502:physiology*; D010053:Ovary / Q000502:physiology; D010062:Ovulation Induction; D012189:Retrospective Studies