Influência da endometriose sobre a resposta ovariana em ciclos de reprodução assistida: provável associação com prejuízo do desenvolvimento folicular, mas não do pool de reserva

Bruno Ramalho de Carvalho
In: Universidade de São Paulo · 2008 · doi:10.11606/d.17.2008.tde-08042015-125304 · W4234099022
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Endometriosis patients undergoing assisted reproduction had impaired follicular development but a normal ovarian reserve pool, as indicated by AMH, FSH, antral follicle count, and ovarian volume.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This dissertation evaluated ovarian reserve and predictors of “poor response” in 87 assisted reproduction cycles in women under 40 with regular menses, comparing 30 cycles from women with endometriosis-associated subfertility to 57 cycles from women with exclusive male-factor subfertility. Ovarian reserve was assessed using basal anti-Müllerian hormone (AMH) and FSH, antral follicle counts (small antral follicles, CFA), and mean ovarian volume (VOM), with ROC curves used to estimate each test’s ability to discriminate poor response. Endometriosis cycles showed significantly higher basal FSH and fewer oocytes aspirated, while AMH, CFA, and VOM did not differ; importantly, basal FSH correlated with total oocytes aspirated only in the endometriosis group. The paper concludes that AMH is the best discriminative marker for poor response regardless of endometriosis, while caveats include the limited sample size and the reliance on baseline markers and single-cycle measurements for prediction. This paper is centrally about endometriosis — it examines how endometriosis affects ovarian response in assisted reproduction and which ovarian reserve markers best predict poor response.

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Abstract

Introduo: A avaliao da reserva ovariana em reproduo assistida (RA) busca identificar mulheres em que a exausto folicular determine as dificuldades reprodutivas. Alm da idade, a presena de causas outras de subfertilidade, como a endometriose (EDT), implica interferncias negativas potenciais sobre a resposta ovariana. Objetivo: Avaliar a reserva folicular ovariana de mulheres subfrteis portadoras de endometriose e determinar o melhor preditor de m resposta em RA. Mtodos: Foram analisados 87 ciclos de RA em mulheres com idade inferior a 40 anos, ciclos menstruais regulares, sem patologias endcrinas e com ambos os ovrios, sendo 30 ciclos em portadoras de EDT (casos) e 57 ciclos em mulheres subfrteis por fator masculino exclusivo (controles). A reserva ovariana foi inferida pelas dosagens basais dos hormnios anti-mlleriano (AMH) e folculo estimulante (FSH), a contagem de folculos antrais pequenos (CFA) e a medida do volume ovariano mdio (VOM).

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