The impact of endometrioma size on ovarian responsiveness

Somigliana E, Edgardo Somigliana, Maria Cruz Palomino, Palomino MC, M Cruz Palomino, Marta Castiglioni, Castiglioni M, Laura Mensi, Mensi L, Laura Benaglia, Benaglia L, Paolo Vercellini, Juan Garcia-Velasco, Garcia-Velasco J, Juan A. García-Velasco
Reproductive BioMedicine Online · 2020 · vol. 41(2) , pp. 343–348 · doi:10.1016/j.rbmo.2020.03.003 · PMID:32475752 · W3011999678
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This study investigated how endometrioma size affects ovarian response to stimulation and found that larger endometriomas correlate with reduced ovarian response.

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Abstract

RESEARCH QUESTION: Available evidence shows that the presence of ovarian endometriomas does not interfere with the ovarian response to ovarian stimulation. However, the mean size of the endometriomas in these studies is generally small, and two recent investigations suggested that follicular development could be impaired when focusing on larger endometriomas. However, these studies could not identify a clear threshold above which endometriomas could become detrimental. DESIGN: To identify this threshold, the study retrospectively selected women without a history of surgery for ovarian cysts who underwent IVF in the presence of unilateral endometriomas with a mean diameter between 20 and 49 mm. Selected women were divided into three categories of endometrioma size: 20-29 mm (group 1, n = 23), 30-39 mm (group 2, n = 2323), and 40-49 mm (group 3, n = 2321). Recruitment for each category was censored at about 21 women to ensure equal statistical power for each group. RESULTS: The response to ovarian stimulation was equal or superior in the affected gonads in eight women (35%, 95% confidence interval [CI] 16-57%), seven women (30%, 95% CI 13-53%) and two women (10%, 95% CI 2-30%) in groups 1, 2 and 3, respectively. The median (interquartile range) number of developed follicles in the affected and intact ovaries was 6 (3-7) and 5 (4-9) in group 1 (P = 0.21), 4 (1-6) and 4 (3-7) in group 2 (P = 0.08), 5 (3-7), and 7 (4-8) in group 3 (P = 0.01), respectively. CONCLUSIONS: The threshold to be used to distinguish between endometriomas that might and might not interfere with ovarian response is 4 cm in diameter.

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Condition tags

endometriosisendometrioma

MeSH descriptors

Endometriosis Fertilization in Vitro Fertilization in Vitro Ovarian Diseases Ovulation Induction Ovulation Induction Adult Adult Endometriosis Endometriosis Female Female Humans Humans Ovarian Diseases Ovarian Diseases Ovarian Reserve Ovarian Reserve Ovarian Reserve Retrospective Studies

Citation neighborhood (2-hop)

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. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (27)

Cited by (25)

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