Removal of endometriomas before in vitro fertilization does not improve fertility outcomes: a matched, case–control study

Juan A Garcia-Velasco, Juan A. García-Velasco, Garcia-Velasco JA, Mahutte NG, Neal Mahutte, Neal G Mahutte, José Corona, Corona J, Zúñiga V, Victor Zúñiga, Juan Gilés, Gilés J, Aydın Arıcı, Arici A, Aydin Arici, Antonio Pellicer, António Pellicer
Fertility and sterility · 2004 · vol. 81(5) , pp. 1194–1197 · doi:10.1016/j.fertnstert.2003.04.006 · PMID:15136074 · W2105721003
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This matched case-control study found that removing endometriomas before IVF did not improve pregnancy or implantation rates compared to patients who did not undergo surgery.

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Abstract

ObjectiveTo investigate whether conservative surgery on ovarian endometriomas before an IVF cycle improves fertility outcomes.DesignRetrospective, matched case-control study.SettingTwo academic IVF programs.Patient(s)One hundred eighty-nine women with endometriomas who underwent IVF treatment: 56 women proceeded directly to IVF, and 133 first underwent conservative ovarian surgery.Intervention(s)Controlled ovarian hyperstimulation and IVF-ET.Main outcome measure(s)Response to gonadotropins, fertilization, implantation, and pregnancy rates.Result(s)Aside from lower peak E(2) levels on the day of hCG and a higher total FSH dose in women previously operated for an endometrioma, no significant differences were found between the two groups in the different IVF variables analyzed.Conclusion(s)Laparoscopic cystectomy for endometriomas before commencing an IVF cycle does not improve fertility outcomes. Proceeding directly to controlled ovarian hyperstimulation in women with asymptomatic ovarian endometriomas might reduce the time to pregnancy, the costs of treatment, and the hypothetical complications of laparoscopic surgery. Conversely, conservative surgical treatment of ovarian endometriomas in symptomatic women does not impair IVF or intracytoplasmic sperm injection success rates.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Fertility Fertilization in Vitro Ovarian Diseases Adult Case-Control Studies Cystectomy Endometriosis Female Humans Laparoscopy Ovarian Diseases Retrospective Studies

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