title: Ovarian endometriomas and IVF: a retrospective case-control study.
abstract: We performed this retrospective case-control study analyzing 428 first-attempt in vitro fertilization (IVF) cycles, among which 254 involved women with a previous or present diagnosis of ovarian endometriosis. First, the results of these 254 cycles were compared with 174 cycles involving patients with proven non-endometriotic tubal infertility having similar age and body mass index. Women with ovarian endometriosis had a significantly higher cancellation rate, but similar pregnancy, implantation and delivery rates as patients with tubal infertility. Second, among the women with ovarian endometriosis, the women with a history of laparoscopic surgery for ovarian endometriomas prior to IVF and no visual endometriosis at ovum pick-up (n = 112) were compared with the non-operated women and visual endometriomas at ovum pick-up (n = 142). Patients who underwent ovarian surgery before IVF had significantly shorter period, lower antral follicle count and required higher gonadotropin doses than patients with non-operated endometriomas. The two groups of women with a previous or present ovarian endometriosis did, however, have similar pregnancy, implantation and live birth rates. In conclusion, ovarian endometriosis does not reduce IVF outcome compared with tubal factor. Furthermore, laparoscopic removal of endometriomas does not improve IVF results, but may cause a decrease of ovarian responsiveness to gonadotropins.
authors.affiliation: Department of Obstetrical and Gynecological Sciences, University of Torino, Anna Hospital, Torino, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Bongioanni
authors.forename: Alberto
authors.initials: A
authors.lastname: Revelli
authors.forename: Gianluca
authors.initials: G
authors.lastname: Gennarelli
authors.forename: Daniela
authors.initials: D
authors.lastname: Guidetti
authors.forename: Luisa Delle
authors.initials: LD
authors.lastname: Delle Piane
authors.forename: Jan
authors.initials: J
authors.lastname: Holte
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D010064:Embryo Implantation; D004715:Endometriosis / Q000150:complications / Q000601:surgery*; D005187:Fallopian Tubes / Q000503:physiopathology*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007247:Infertility, Female / Q000209:etiology*; D010535:Laparoscopy / Q000009:adverse effects; D054315:Oocyte Retrieval; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D016896:Treatment Outcome