OC09: Does laparoscopic cystectomy for bilateral endometriomas affect ovarian reserve? Insight from b‐FSH and ovarian response to gonadotrophin stimulation for ART

To evaluate whether endometrioma surgery could reduce ovarian reserve and its effect on ART outcomes. Data from 312 infertile patients referred for IVF-ET/ICSI were reviewed. Twenty women who underwent laparoscopic excision of bilateral endometriotic ovarian cysts before IVF-ET/ICSI were selected and compared with 19 women submitted to laparoscopic cystectomy for monolateral endometrioma and 33 women who never underwent ovarian surgery (tubal factor and endometriosis stages I–II). Basal FSH and follicular responses to gonadotrophin stimulation were compared. Basal FSH in the bilateral endometrioma group was significantly higher than in both the monolateral endometrioma group and patients who had no surgery for endometriotic cyst (10.5 ± 5.4, 7.3 ± 3.2 and 6.8 ± 2.2 mIU/mL respectively) (P < 0.05). The mean ( ± SD) number of follicles after ovarian stimulation was 7.05 ± 4.8 in bilateral cystectomy ovaries and 12.4 ± 6.8 in the ovaries with no previous surgery (P < 0.05). When compared with monolateral cystectomy ovaries, the mean follicular response was similar (7.05 ± 4.8 vs. 8.8 ± 5.6). Cystectomy for endometrioma is associated with ovarian damage. Patients who have been operated on for bilateral endometrioma have a higher risk of reduction in ovarian reserve.