Effects of Cystectomy for Ovarian Endometrioma on Ovarian Response and Outcome of in Vitro Fertilization and Embryo Transfer Cycle

Objective:To investigate ovarian response to controlled ovarian hyperstimulation during IVF and pregnancy outcome in patients who previously underwent laparoscopic cystectomy for endometriomas.Methods:There were 52 cases(65cycle) of in vitro fertiliation embryo transfer patients who had been removed ovarian endometriosis cyst by laparoscopy were included as study group, in which 20 cases experienced bilateral ectopic cystectomy and 32 cases underwent unilateral ectopic cystectomy.In contrast, 104 patients(129 cycles) with tubal-factor infertility were included as control group.The women in the study group and those in the control group underwent 65 and 129 IVF-ET cycles, respectively.The related indices of ovarian response and pregnancy outcome were collected as statistical data for retrospective analysis.Results:There is no statistically difference among 3 group for the following parameters, such as age,body mass index, infertility years,basal FSH level,gonadotropin period, the fertilization rate and estradiol(E2) on the day of injecting human chorionic gonadotropin(hCG)(P 0.05).Meanwhile there is slightly higher rate of pregnancy rate in the unilateral cyst removed group.The lower the retrieve follicles, good-quality embryonic rate and the frozen embryos, the higher the total gonadotropin requirements that were found in women with endometriosis compared with tubal-factor control subjects.In addition, the surgical side of retrieve follicles of the unilateral removed group was significantly lower than those in the unsurgical side ovary.Conclusion:The cystectomy for ovarian endometrioma has a negative impact on IVF-ET, resulting in an increase of the total amount of Gn, a decrease of the number of retrieved oocytes and good-quality embryo.Ectopic cystectomy do have some undesirable impact on IVF cycles, but there was no significant effect on the outcome of pregnancy.