title: Endometriotic ovarian cysts do not negatively affect the rate of spontaneous ovulation.
abstract: OBJECTIVE
  Do endometriotic ovarian cysts influence the rate of spontaneous ovulation?
  
  
  CONCLUSIONS
  Endometriotic cysts, no matter what their volume, do not influence the rate of spontaneous ovulation in the affected ovary.
  
  
  BACKGROUND
  Endometriotic ovarian cysts may negatively affect spontaneous ovulation in the affected ovary.
  
  
  METHODS
  This was a prospective observational study performed between September 2009 and June 2013.
  
  
  METHODS
  This study included women of reproductive age with regular menstrual cycles and unilateral ovarian endometriomas (diameter ≥20 mm) desiring to conceive. Exclusion criteria were: hormonal therapies in the 3 months prior to study entry and previous adnexal surgery. Patients underwent serial transvaginal ultrasound to assess the side of ovulation (for up to six cycles).
  
  
  RESULTS
  Ovulation was monitored in 1199 cycles in 244 women (age, mean ± SD, 34.3 ± 4.9 years). 55.3% of the patients had left endometriomas and 44.7% had right endometriomas (P = 0.024). The mean (±SD) diameter of the endometriomas was 5.3 cm (±1.7 cm). Ultrasonographically documented ovulation occurred in 596 cycles in the healthy ovary (49.7%; 95% CI, 46.8-52.6%) and in 603 cycles in the affected ovary (50.3%; 95% CI, 47.1-53.2%; P = 0.919). This observation was confirmed in patients with diameter of the cyst ≥4 cm (n = 166) and in those with diameter of the cyst ≥6 cm (n = 45). One hundred and five patients spontaneously conceived (43.0%; 95% CI, 36.7-49.5%).
  
  
  CONCLUSIONS
  The high pregnancy rate reported in this study was observed in a selected population of women with endometriomas and cannot be extrapolated to all patients with endometriosis.
  
  
  CONCLUSIONS
  Since ovarian endometriomas do not impair spontaneous ovulation, the impact on fertility of surgical excision of ovarian endometriomas should be further investigated.
authors.affiliation: Obstetrics and Gynaecology Unit, IRCCS San Martino Hospital and National Institute for Cancer Research, University of Genoa, 16132 Genoa, Italy ulrm@me.com.
authors.forename: U
authors.initials: U
authors.lastname: Leone Roberti Maggiore
authors.affiliation: Obstetrics and Gynaecology Unit, IRCCS San Martino Hospital and National Institute for Cancer Research, University of Genoa, 16132 Genoa, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Scala
authors.affiliation: Obstetrics and Gynaecology Unit, IRCCS San Martino Hospital and National Institute for Cancer Research, University of Genoa, 16132 Genoa, Italy.
authors.forename: P L
authors.initials: PL
authors.lastname: Venturini
authors.affiliation: Obstetrics and Gynaecology Unit, IRCCS San Martino Hospital and National Institute for Cancer Research, University of Genoa, 16132 Genoa, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Remorgida
authors.affiliation: Obstetrics and Gynaecology Unit, IRCCS San Martino Hospital and National Institute for Cancer Research, University of Genoa, 16132 Genoa, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Ferrero
mesh_terms: D000328:Adult; D004715:Endometriosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D004717:Endometrium / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007247:Infertility, Female / Q000453:epidemiology / Q000209:etiology; D007558:Italy / Q000453:epidemiology; D059012:Lost to Follow-Up; D009929:Organ Size; D010048:Ovarian Cysts / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D010053:Ovary / Q000000981:diagnostic imaging / Q000503:physiopathology*; D010060:Ovulation; D011247:Pregnancy; D018873:Pregnancy Rate; D012307:Risk Factors; D012720:Severity of Illness Index; D014463:Ultrasonography
keywords: endometriosis; female infertility; menstrual cycle; ovulation; ultrasound