Should endometriomas be treated before IVF–ICSI cycles?

Edgardo Somigliana, Paolo Vercellini, Paola Viganó, Paola Viganò, G. Ragni, Guido Ragni, Pier Giorgio Crosignani
Human reproduction update · 2005 · vol. 12(1) , pp. 57–64 · doi:10.1093/humupd/dmi035 · PMID:16155094 · W2163027394
review OA: bronze CC0 ⤵ 106 in-corpus citations
📄 Open PDF View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

Excision of ovarian endometriomas may decrease ovarian reserve and offers no proven IVF pregnancy benefit, while expectant management carries risks like occult malignancy.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

Abstract

The laparoscopic excision of ovarian endometriomas appears to increase the chances of spontaneous conception, but the value of this treatment in women selected for IVF-ICSI cycles is debated. Studies recruiting women with unilateral disease and comparing ovarian responsiveness in the affected and contralateral intact gonads indicate that excision of endometriomas is associated with a quantitative damage to ovarian reserve. There are no randomized trials comparing laparoscopic excision to expectant management before IVF-ICSI cycles. The idea that surgery increases IVF pregnancy rates is not supported by the available evidence. However, the chance of conception is not the only issue that has to be considered. Some potential drawbacks are associated with both therapeutical strategies. Specifically, costs and hazard of surgical complications support expectant management whereas oocyte retrieval risks, the possibility of missing occult malignancy and endometriosis progression due to ovarian stimulation would favour surgical treatment. Alternative therapeutical options include medical treatment and ultrasound-guided aspiration. Whereas prolonged GnRH agonist down-regulation may be beneficial, data on ultrasound aspiration are more controversial.

My notes (saved in your browser only)

Condition tags

mesh:D004715endometriosis

MeSH descriptors

Endometriosis Ovary Clinical Trials as Topic Endometriosis Endometriosis Endometriosis Female Fertility Fertilization in Vitro Gynecologic Surgical Procedures Gynecologic Surgical Procedures Humans Laparoscopy Male Ovary Pregnancy Risk Factors Sperm Injections, Intracytoplasmic

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (88)

Cited by (50)

Source provenance

europepmc
last seen: 2026-06-04T01:30:01.192114+00:00
openalex
last seen: 2026-06-04T00:00:01.174412+00:00
pubmed
last seen: 2026-05-13T22:15:35.797702+00:00
License: CC0 · commercial use OK