title: Impact of ovarian endometrioma on ovarian responsiveness and IVF: a systematic review and meta-analysis.
abstract: In this systematic review and meta-analysis, the effect of ovarian endometrioma on ovarian responsiveness to stimulation and on assisted reproduction outcomes was evaluated. Nine published studies (1039 cases) were included. The number of oocytes retrieved (mean difference [MD] -1.50; 95% CI, -2.84 to -0.15, P = 0.03), metaphase II (MII) oocytes retrieved (MD -3.61; 95% CI -4.44 to -2.78, P < 0.00001) and total embryos formed (MD -0.66; 95% CI -1.13 to -0.18, P = 0.007) were significantly lower in women with ovarian endometrioma than the control group. Gonadotrophin dose, duration of stimulation, number of good-quality embryos, implantation rate, clinical pregnancy rate and live birth rate were similar. Comparisons between ovaries with endometriomas and healthy ovaries of the same individuals were also made. Number of oocytes retrieved, MII oocytes retrieved and total embryos formed were not statistically significantly different between the affected ovaries and contralateral normal ovaries. Observational studies showed that ovarian endometrioma was associated with fewer oocytes retrieved, fewer MII oocytes retrieved and fewer total formed embryos. Clinical pregnancy rate and live birth rates were not affected. Intra-patient comparisons in women with unilateral endometrioma suggested the number of oocytes retrieved, MII oocytes retrieved and total embryos formed were similar.
authors.affiliation: Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
authors.forename: Chun
authors.initials: C
authors.lastname: Yang
authors.affiliation: Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
authors.forename: Yuhong
authors.initials: Y
authors.lastname: Geng
authors.affiliation: Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
authors.forename: Yanhui
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
authors.forename: Chunyan
authors.initials: C
authors.lastname: Chen
authors.affiliation: Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China. Electronic address: 1211746863@qq.com.
authors.forename: Ying
authors.initials: Y
authors.lastname: Gao
mesh_terms: D001723:Birth Rate; D010064:Embryo Implantation; D004715:Endometriosis / Q000473:pathology*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D010049:Ovarian Diseases / Q000473:pathology*; D010053:Ovary / Q000187:drug effects*; D010062:Ovulation Induction; D011247:Pregnancy; D018873:Pregnancy Rate; D013997:Time Factors; D016896:Treatment Outcome
keywords: in vitro fertilization; meta-analysis; ovarian endometrioma; ovarian responsiveness