title: Is there a critical endometrioma size associated with reduced ovarian responsiveness in assisted reproduction techniques?
abstract: This study investigated the relationships between ovarian endometrioma size, ovarian responsiveness and the number of retrieved oocytes following ovarian stimulation. A prospective study was conducted in a public clinical assisted reproduction centre. A total of 64 infertile women with monolateral endometriomas undergoing IVF or intracytoplasmic sperm injection were included in the study. The total number of follicles, number of follicles ≥ 16 mm and number of oocytes retrieved of ovaries containing endometrioma and normal ovaries were compared. Multivariate linear regression was used to assess whether number of follicles and collected oocytes varied by endometrioma size, age, basal FSH concentration. Significantly lower numbers of follicles ≥ 16 mm (P = 0.024) and oocytes retrieved (P = 0.001) in the ovaries containing endometrioma were observed. In patients with endometriomas ≥ 30 mm, endometrioma size was the most influential contributor to the total number of follicles and oocytes retrieved. Ovarian endometriomas result in reduced response to ovarian stimulation, compared with the response of the contralateral normal ovary in the same individual. In case of endometriomas <30 mm, basal FSH concentration remains the most important prognostic factor for oocyte retrieval.
authors.affiliation: Department of Science for the Health of Woman and Child, University of Florence, Florence, Italy; Ospedale Versilia, Centro di Procreazione medicalmente assistita, Lido di Camaiore (LU), Italy.
authors.forename: Maria Elisabetta
authors.initials: ME
authors.lastname: Coccia
authors.affiliation: Ospedale Versilia, Centro di Procreazione medicalmente assistita, Lido di Camaiore (LU), Italy; Department of Experimental Medicine, Section of Medical Physiopathology, University of Rome 'La Sapienza', Rome, Italy. Electronic address: francesca.rizzello@libero.it.
authors.forename: Francesca
authors.initials: F
authors.lastname: Rizzello
authors.affiliation: Ospedale Versilia, Centro di Procreazione medicalmente assistita, Lido di Camaiore (LU), Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Barone
authors.affiliation: Ospedale Versilia, Centro di Procreazione medicalmente assistita, Lido di Camaiore (LU), Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Pinelli
authors.affiliation: Ospedale Versilia, Centro di Procreazione medicalmente assistita, Lido di Camaiore (LU), Italy.
authors.forename: Erika
authors.initials: E
authors.lastname: Rapalini
authors.affiliation: Ospedale Versilia, Centro di Procreazione medicalmente assistita, Lido di Camaiore (LU), Italy.
authors.forename: Cristiana
authors.initials: C
authors.lastname: Parri
authors.affiliation: Ospedale Versilia, Centro di Procreazione medicalmente assistita, Lido di Camaiore (LU), Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Caracciolo
authors.affiliation: Ospedale Versilia, Centro di Procreazione medicalmente assistita, Lido di Camaiore (LU), Italy.
authors.forename: Savvas
authors.initials: S
authors.lastname: Papageorgiou
authors.affiliation: Ospedale Versilia, Centro di Procreazione medicalmente assistita, Lido di Camaiore (LU), Italy.
authors.forename: Gianpaolo
authors.initials: G
authors.lastname: Cima
authors.affiliation: Department of Experimental Medicine, Section of Medical Physiopathology, University of Rome 'La Sapienza', Rome, Italy.
authors.forename: Loredana
authors.initials: L
authors.lastname: Gandini
mesh_terms: D000328:Adult; D016889:Endometrial Neoplasms / Q000503:physiopathology*; D004715:Endometriosis / Q000503:physiopathology*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000378:metabolism; D006801:Humans; D010053:Ovary / Q000503:physiopathology*; D011446:Prospective Studies; D027724:Reproductive Techniques, Assisted
chemical_list: D005640:Follicle Stimulating Hormone
keywords: IVF; assisted reproduction; endometrioma; oocytes; ovarian stimulation