title: The vanishing endometrioma: the intriguing impact of pregnancy on small endometriotic ovarian cysts.
abstract: There is a general belief that pregnancy has a beneficial effect on endometriosis but evidence is scanty. Moreover, some recent warning reports documented progression-growth of ovarian endometriomas during pregnancy. To further elucidate this aspect, we set up a prospective cohort study. We recruited 24 women carrying endometriomas at the time of in vitro fertilization who got pregnant. Selected women were contacted about 12-18 months after oocyte retrieval and invited to refer for ultrasound. The primary aim was to evaluate the modifications of endometriotic cysts after pregnancy. Twenty-four women carrying 40 endometriomas accepted to participate. The number of cysts per patient was significantly reduced following pregnancy (p = 0.003). It was unchanged in eight cases (33%), increased in two cases (8%) and reduced in three cases (13%). In the remaining 11 women (46%), no cyst could be detected. A comparison of the size of the endometrioma could be done in 21 cysts; the mean ± SD diameter before and after pregnancy was 20 ± 9 and 18 ± 7 mm, respectively (p = 0.27). In conclusion, pregnancy has a beneficial effect on endometriomas. A consistent proportion of cysts becomes undetectable after delivery. Further studies are warranted to clarify the mechanisms determining the disappearance of these cysts.
authors.affiliation: Department of Obstet-Gynecol, Infertility Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Benaglia
authors.forename: Edgardo
authors.initials: E
authors.lastname: Somigliana
authors.forename: Luca
authors.initials: L
authors.lastname: Calzolari
authors.forename: Andrea
authors.initials: A
authors.lastname: Busnelli
authors.forename: Lucia
authors.initials: L
authors.lastname: Cardellicchio
authors.forename: Guido
authors.initials: G
authors.lastname: Ragni
authors.forename: Luigi
authors.initials: L
authors.lastname: Fedele
mesh_terms: D000328:Adult; D015331:Cohort Studies; D036861:Delivery, Obstetric; D004715:Endometriosis / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007231:Infant, Newborn; D009929:Organ Size; D010048:Ovarian Cysts / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy; D011247:Pregnancy / Q000502:physiology*; D011248:Pregnancy Complications / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy; D012075:Remission, Spontaneous