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. 2002 Nov;19(11):507–511. doi: 10.1023/A:1020970417778

Poor Response of Ovaries with Endometrioma Previously Treated with Cystectomy to Controlled Ovarian Hyperstimulation

Hsin-Yi Ho 1, Robert Kuo-Kuang Lee 1,2,✉, Yuh-Ming Hwu 1, Ming-Huei Lin 1, Jin-Tsung Su 1, Yi-Chun Tsai 1
PMCID: PMC3455345  PMID: 12484492

Abstract

Purpose: To compare ovarian response to controlled ovarian hyperstimulation (COH) between normal ovaries and ovaries previously treated surgically for unilateral ovarian endometrioma.

Methods: From January 1996 to December 2001, 32 patients with unilateral ovarian endometrioma previously treated surgically underwent 38 cycles of COH. Their records were reviewed retrospectively. The number of dominant follicles observed on the day of hCG injection and the number of eggs retrieved from the diseased and the normal ovaries in each patient were compared.

Results: The numbers of dominant follicles from diseased and normal ovaries were 1.9 ±1.5 and 3.3 ± 2.1, respectively (P < 0.001). During ovum pick up, the numbers of eggs retrieved from diseased and normal ovaries were 2.9 ± 2.6 and 6.1 ± 4.1, respectively (P < 0.0001). For diseased ovaries, 21.1% (8/38) had no dominant follicles, while only 7.9% (3/38) of normal ovaries lacked dominant follicles. The clinical pregnancy rate and the implantation rate per embryo transfer were 33.3 and 17.6%.

Conclusions: Surgery for ovarian endometrioma may damage ovarian reserve. It potentially results in poor ovarian response to COH, compared to the response of the contralateral normal ovary in the same individual.

Keywords: Endometrioma, ovarian cystectomy, ovarian reserve

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REFERENCES

  • 1.Hemmings R, Bissonnette F, Bouzayen R. Results of laparoscopic treatments of ovarian endometriomas: Laparoscopic ovarian fenestration and coagulation. Fertil Steril. 1998;70:527–529. doi: 10.1016/s0015-0282(98)00219-2. [DOI] [PubMed] [Google Scholar]
  • 2.Beretta P, Franchi M, Ghezzi F, Busacca M, Zupi E. B. Randomized clinical trial of two laparoscopic treatments of endometriomas: Cystectomy versus drainage and coagulation. Fertil Steril. 1998;70:1176–1180. doi: 10.1016/s0015-0282(98)00385-9. [DOI] [PubMed] [Google Scholar]
  • 3.Donnez J, Nisolle M, Gillet N, Smet M, Bassil S, Casanas-Roux F. Large ovarian endometriomas. Hum Reprod. 1996;11:641–646. doi: 10.1093/humrep/11.3.641. [DOI] [PubMed] [Google Scholar]
  • 4.Maneschi F, Marasa L, Incandela S, Mazzarese M, Zupi E. Ovarian cortex surrounding benign neoplasms: A histologic study. Am J Obstet Gynecol. 1993;169:388–393. doi: 10.1016/0002-9378(93)90093-x. [DOI] [PubMed] [Google Scholar]
  • 5.Kaplan CR, Eddy CA, Olive DL, Schenken RS. Effect of ovarian endometriosis on ovulation in rabbits. AmJ Obstet Gynecol. 1989;160:40–44. doi: 10.1016/0002-9378(89)90083-5. [DOI] [PubMed] [Google Scholar]
  • 6.Isaacs JD, Hines RS, Sopelak VM, Cowan BD. Ovarian endometriomas do not adversely affect pregnancy success following treatment with in vitro fertilization. J Assist Reprod Genet. 1997;14:551–553. doi: 10.1023/A:1022592715006. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 7.Williams CM, Yuen BH, Klein NA, Allaire C, Rowe TC. Ovarian endometriomas during IVF treatment: Do they affect outcomes? Fertil Steril. 1998;70:S19. [Google Scholar]
  • 8.Beretta P, Franchi M, Ghezzi F. Management of ovarian endometriomas and pregnancy? Reply. Fertil Steril. 1999;71:1166–1167. [PubMed] [Google Scholar]
  • 9.Jones K, Sutton C. Endometriomas: Fenestration of excision? Fertil Steril. 2000;74:846–847. doi: 10.1016/s0015-0282(00)01503-x. [DOI] [PubMed] [Google Scholar]
  • 10.Jones KD, Sutton CJG. Pregnancy rates following ablative laparoscopic surgery for endometriomas. Hum Reprod. 2002;17:782–785. doi: 10.1093/humrep/17.3.782. [DOI] [PubMed] [Google Scholar]
  • 11.Saleh A, Tulandi T. Reoperation after laparoscopic treatment of ovarian endometriomas by excision and by fenestration. Fertil Steril. 1999;72:322–324. doi: 10.1016/s0015-0282(99)00243-5. [DOI] [PubMed] [Google Scholar]
  • 12.Donnez J, Wyns C, Michelle N. Does ovarian surgery for endometriomas impair the ovarian response to gonadotropin? Fertil Steril. 2001;76:662–665. doi: 10.1016/s0015-0282(01)02011-8. [DOI] [PubMed] [Google Scholar]
  • 13.Donnez J, Chantraine F, Nisolle M. The efficacy of medical and surgical treatment of endometriosis-associated infertility: Arguments in favour of a medico-surgical approach. HumReprod Update. 2002;8:89–94. doi: 10.1093/humupd/8.1.89. [DOI] [PubMed] [Google Scholar]
  • 14.Brosens I. Management of ovarian endometriomas and pregnancy? Fertil Steril. 1999;71:1166. [PubMed] [Google Scholar]
  • 15.Canis M, Pouly JL, Tamburro S, Mage G, Bruhat MA. Ovarian response during IVF-embryo transfer cycles after laparoscopic ovarian cystectomy for endometriotic cysts of >3cm in diameter. Hum Reprod. 2001;16:2583–2586. doi: 10.1093/humrep/16.12.2583. [DOI] [PubMed] [Google Scholar]
  • 16.Fayez JA, Vogel MF. Comparison of different treatment methods of endometriomas by laparoscopy. Obstet Gynecol. 1991;78:660–665. [PubMed] [Google Scholar]
  • 17.Al-Azemi M, Bernal AL, Steele J, Gramsbergen I, Barlow D, Kennedy S. Ovarian response to repeated controlled stimulation in in-vitro fertilization cycles in patients with ovarian endometriosis. Hum Reprod. 2000;15:72–75. doi: 10.1093/humrep/15.1.72. [DOI] [PubMed] [Google Scholar]
  • 18.Hachisuga T, Kawarabayashi T. Histopathological analysis of laparoscopically treated ovarian endometriotic cysts with special reference to loss of follicles. Hum Reprod. 2002;17:432–435. doi: 10.1093/humrep/17.2.432. [DOI] [PubMed] [Google Scholar]
  • 19.Tulandi T, Saleh A. Endometriomas: Fenestration of excision? Reply. Fertil Steril. 2000;74:847–848. doi: 10.1016/s0015-0282(00)01503-x. [DOI] [PubMed] [Google Scholar]
  • 20.Loh FH, Tan AT, Kumar J, Ng SC. Ovarian response after laparoscopic ovarian cystectomy for endometriotic cysts in 132 monitored cycles. Fertil Steril. 1999;72:316–321. doi: 10.1016/s0015-0282(99)00207-1. [DOI] [PubMed] [Google Scholar]
  • 21.Thomson AJ, Gazvani MR, Wood SJ, Meacock S. L. D., Kingsland CR. Comparison of ovarian response in right and left ovaries in IVF patients. Hum Reprod. 2001;16:1694–1697. doi: 10.1093/humrep/16.8.1694. [DOI] [PubMed] [Google Scholar]
  • 22.Nargund G, Cheng WC, Parsons J. The impact of ovarian cystectomy on ovarian response to stimulation during in-vitro fertilization cycles. Hum Reprod. 1996;11:81–83. doi: 10.1093/oxfordjournals.humrep.a019043. [DOI] [PubMed] [Google Scholar]
  • 23.Koninckx PR, Muyldermans M, Moerman P, Meuleman C, Deprest J, Cornille F. CA-125 concentrations in ovarian “chocolate” cyst fluid can differentiate an endometriotic cyst from a cystic corpus luteum. Hum Reprod. 1992;7:1314–1317. doi: 10.1093/oxfordjournals.humrep.a137847. [DOI] [PubMed] [Google Scholar]
  • 24.Brosens IA, Puttemans PJ, Deprest J. The endoscopic localization of endometrial implants in the ovarian chocolate cyst. Fertil Steril. 1994;61:1034–1038. doi: 10.1016/s0015-0282(16)56752-1. [DOI] [PubMed] [Google Scholar]
  • 25.Lee KKR: Poor ovarian response during controlled ovarian hyperstimulation after enucleation of ovarian endometrioma. In Proceedings of the SeventeenthWorld Congress on Fertility and Sterility, Nov 25–30, 2001, Melbourne, Australia, p 101

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