Aspiration of ovarian endometriomas before intracytoplasmic sperm injection

Pabuccu R, Recai Pabuçcu, Recai Pabuccu, Onalan G, Gogsen Onalan, Göğşen Önalan, Ümit Göktolga, Goktolga U, Umit Goktolga, Tansu Küçük, Tansu Kucuk, Kucuk T, Orhon E, Esat Orhon, Temel Ceyhan, Ceyhan T
Fertility and Sterility · 2004 · vol. 82(3) , pp. 705–711 · doi:10.1016/j.fertnstert.2004.02.117 · PMID:15374718 · W2026649984
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This study investigated the outcomes of intracytoplasmic sperm injection following aspiration of ovarian endometriomas.

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Abstract

ObjectiveTo investigate whether aspiration of ovarian endometriomas before controlled ovarian stimulation (COH) improves intracytoplasmic sperm injection (ICSI) outcomes.DesignProspective study.SettingUniversity hospital.Patient(s)A prospective analysis of 171 patients with ovarian endometriosis and tubal factor infertility were divided into four groups: aspiration of endometriomas at the beginning of COH in patients with ovarian endometriomas and no history of previous surgery (n = 41) (group 1); nonaspirated endometriomas (n = 40) (group 2); history of ovarian surgery for endometriomas in patients without ovarian endometriomas at the beginning of COH (n = 44) (group 3); and tubal factor infertility (n = 46) (control group 4).Intervention(s)Aspiration of endometriomas.Main outcome measure(s)Clinical parameters, characteristics of COH, and ICSI results were analyzed.Result(s)We observed higher levels of E(2) on the day of hCG injection after aspiration of endometriomas compared with nonaspirated endometriomas. When we compared all endometriomas and tubal factor (control) groups, we observed a lower number of total follicles (>17 mm) and metaphase II (MII) oocytes in nonaspirated and resected endometrioma groups and a longer duration of COH in the nonaspirated endometrioma group compared with the tubal factor group. Implantation and clinical pregnancy rates were similar among all groups.Conclusion(s)In the current study, all patients with endometriomas had significantly lower numbers of MII oocytes compared with those in patients with tubal factor infertility. We propose that aspiration of endometriomas before COH neither reduces the amount of gonadotropins nor increases the number of follicles >17 mm, the number of MII oocytes retrieved, the implantation rates, or the clinical pregnancy rates. Resection of small endometriomas (1-6 cm) may not present any additional benefits to the IVF-ICSI cycle outcomes.

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Condition tags

endometriosis

MeSH descriptors

Endometrial Neoplasms Endometriosis Sperm Injections, Intracytoplasmic Endometrial Neoplasms Endometriosis Female Humans Male Ovulation Induction Ovulation Induction Retrospective Studies Treatment Outcome Vacuum Curettage

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