Laparoscopic excision of ovarian endometrioma does not exert a qualitative effect on ovarian function: insights from in vitro fertilization and single embryo transfer cycles

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Laparoscopic endometrioma excision did not negatively impact oocyte fertilization or embryo quality, despite fewer oocytes being retrieved from operated ovaries.

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This retrospective study evaluated whether laparoscopic excision of ovarian endometriomas affects oocyte quality by comparing ovaries with prior endometrioma excision to contralateral healthy ovaries in 21 patients undergoing IVF with controlled ovarian stimulation. Using oocyte-level outcomes, 55 oocytes from endometrioma-excised ovaries were compared with 128 from healthy ovaries for normal fertilization rate and the proportion of top-quality embryos per normally fertilized egg, and embryo-level outcomes were compared in 34 single-embryo-transfer cycles. Oocytes from endometrioma-excised ovaries yielded fewer oocytes overall, but fertilization rates, top-quality embryo rates, and clinical and ongoing pregnancy rates per embryo were similar between groups. Limitations include the small sample size for qualitative comparisons and the retrospective design. This paper is centrally about endometriosis — it examines how laparoscopic excision of ovarian endometriomas influences oocyte and embryo quality in IVF cycles.

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Abstract

Purpose To evaluate whether laparoscopic excision of endometrioma exerts a qualitative effect on ovarian function.

Methods

A retrospective analysis of oocytes retrieved in 25 cycles of 21 patients undergoing IVF treatment with controlled ovarian stimulation. The number of oocytes recovered from ovaries with a history of excision of endometrioma (E-Ov) were compared to those from contra-lateral healthy ovaries (H-Ov) as for the analysis of a quantitative effect of surgery. As for the analysis of a qualitative effect, 55 oocytes from E-Ov were compared to 128 oocytes from H-Ov in terms of normal fertilization rate and the rate of top-quality embryos per normally fertilized eggs. Furthermore, 10 embryos derived from oocytes recovered from E-Ov were compared to 24 embryos derived from oocytes from H-Ov in terms of clinical and on-going pregnancy rates per embryos in 34 single embryo transfer cycles.

Results

Mean number of oocytes recovered from E-Ov was significantly smaller than that from H-Ov (2.2 ± 2.0 vs. 5.1 ± 3.3, P = 0.009). There was no difference between oocytes from E-Ov and H-Ov as for normal fertilization rate (63.6 % vs. 69.5 %, P = 0.43) and the rate of top-quality embryos (40.0 % vs. 49.0 %, P = 0.34). Clinical and on-going pregnancy rates per embryos were also similar in embryos derived from oocytes recovered from E-Ov and H-Ov (40.0 % vs. 25.0 %, P = 0.39 and 20.0 % vs. 20.8 %, P = 0.96).

Conclusions

The quality of oocytes recovered from the ovary with a history of laparoscopic excision of endometrioma is not inferior to the quality of oocytes from contra-lateral healthy ovary. Similar content being viewed by others

References

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Celik HG, Dogan E, Okyay E, Ulukus C, Saatli B, Uysal S, et al. Effect of laparoscopic excision of endometriomas on ovarian reserve: serial changes in the serum antimullerian hormone levels. Fertil Steril. 2012;97:1472–8. Acknowledgments Authors thank to patients and staff, especially Ms. Nagisa Oi, at the IVF center in University of Tokyo Hospital. Authors also thank to Dr. Akihisa Fujimoto, Dr. Hajime Oishi, Dr. Masashi Takamura, and Dr. Gentaro Izumi for their valuable comments. Compliance with ethical standards ᅟ Funding This work was supported by Grant-in-Aids for Scientific Research from Japan Society for the Promotion of Science. Conflict of interest The authors declare that they have no conflict of interest. Ethical approval All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required. Informed consent Informed consent was obtained from all individual participants included in the study. Author information Authors and Affiliations Corresponding author Additional information Capsule The quality of oocytes recovered from the ovary with a history of laparoscopic excision of endometrioma is not inferior to the quality of oocytes from contra-lateral healthy ovary. Rights and permissions About this article Cite this article Harada, M., Takahashi, N., Hirata, T. et al. Laparoscopic excision of ovarian endometrioma does not exert a qualitative effect on ovarian function: insights from in vitro fertilization and single embryo transfer cycles. J Assist Reprod Genet 32, 685–689 (2015). https://doi.org/10.1007/s10815-015-0457-7 Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s10815-015-0457-7

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Condition tags

endometriosisendometrioma

MeSH descriptors

Embryo, Mammalian Endometriosis Fertilization in Vitro Laparoscopy Ovary Quality Control Single Embryo Transfer Adult Embryo, Mammalian Endometriosis Endometriosis Female Fertilization in Vitro Humans Infertility, Female Infertility, Female Oocytes Oocytes Ovary Ovary

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