Poor Ovarian Response with High Cancellation Rate during Controlled Ovarian Hyperstimulation after Enucleation of Ovarian Endometriomas

Objective: To evaluate ovarian response during controlled ovarian hyperstimulation (COH) in patients with endometriomas previously treated surgically. Material(s) and Method(s): The medical records of patients under 40 years old undergoing IVF from January 1992 to December 1999 were retrospectively reviewed. In group 1 (51 patients, 71 cycles), all patients had undergone cystectomy for ovarian endometriomas prior to IVE. A control group 2 (48 patients, 52 cycles) had had male factor infertility and had undergone ICSI. The ovarian response and cancellation rates of these two groups during COH were compared. Result(s): The cancellation rate in group 1 was significantly higher than in group 2 (28.2% vs. 7.7%, P＜0.05). The estradiol level and number of dominant follicles on the day of hCG injection, the number of mature oocytes retrieved, and the number of embryos available were all significantly lower in group 1. There were no statistical differences in the clinical pregnancy rate (32.0% vs. 42.6%), implantation rate (13.1% vs. 15.1%) or live birth rate (30.0% vs. 31.9%). Conclusion(s): Ovarian surgery may damage ovarian reserve, resulting in poor ovarian response and increased cancellation rate during COH.