Endometriosis and Ovarian Reserve : Graduation Thesis

Aim: To investigate ovarian response to stimulation drugs in participants with endometrioma treated with IVF only or with surgery prior to IVF. Methods: A retrospective analysis of medical records of patients with a diagnosis of endometrioma by ultrasonography or confirmed by laparoscopy. Results: In total, 98 IVF cycles were analyzed; 55.1% involved prior surgery for endometrioma, and 44.9% did not. Participants in the surgery group were significantly younger (33.25 vs 36.04 years, p = 0.002), time to treatment and mean oocyte yield were similar for both groups. Age-stratified analysis revealed that the non-surgical group had higher oocyte counts across most age ranges, suggesting a better ovarian response without prior surgery. Most surgical procedures (77.8%) occurred before IVF treatment. The subgroup of participants treated by surgery before IVF had the lowest mean number of aspirated oocytes; on the contrary, the participants subgroup treated by IVF before surgery had the highest number of aspirated oocytes. Conclusion: Younger women are more often treated with surgery for endometrioma as a first-line treatment. Despite being the youngest group, patients who had surgery before IVF had the lowest mean oocyte yield and the longest delay to IVF treatment. Delayed IVF treatment in the surgery group may reflect expectations of natural conception after surgery.