Do ovarian endometriomas affect ovarian response to ovarian stimulation for IVF/ICSI?

Iñaki González-Foruria, Pedro Barri Soldevila, Soldevila PB, Pere Barri-Soldevila, Ignacio Rodríguez, Jorge Rodríguez-Purata, J. Rodriguez-Purata, Rodríguez-Purata J, Pardos C, C. García Pardos, Clara Pardos, Sandra García, García S, Pascual MÁ, M. Pascual, M Ángela Pascual, Barri PN, Pedro N. Barri, Polyzos NP, Nikolaos P. Polyzos
Reproductive BioMedicine Online · 2020 · vol. 41(1) , pp. 37–43 · doi:10.1016/j.rbmo.2020.03.013 · PMID:32456967 · W3023979607
article OA: closed CC0 ⤵ 15 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study investigated whether ovarian endometriomas influence ovarian response during ovarian stimulation for IVF/ICSI.

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Abstract

Research questionDoes the presence of ovarian endometriomas affect ovarian response to ovarian stimulation after adjusting for age and ovarian reserve markers?DesignThis retrospective cross-sectional study compared the ovarian response between patients with ovarian endometriomas and women with other infertility factors undergoing their first ovarian stimulation for IVF/intracytoplasmic sperm injection (ICSI). An age-specific nomogram model for the number of oocytes retrieved was built for both groups, and ovarian response was compared after adjusting for age, gonadotrophin dose, anti-Mullerian hormone (AMH) concentration and antral follicle count (AFC).ResultsA total of 923 patients were included: 101 women with at least one ovarian endometrioma, and 822 patients with other infertility factors. Comparisons of the nomograms for the number of oocytes retrieved demonstrated that response was significantly lower for women with endometrioma when the results were adjusted for age the z-score for the number of oocytes retrieved (-0.49 ± 0.71 versus -0.20 ± 0.86; 95% confidence interval [CI] -0.47 to -0.12) and also after adjustment for the total dose of gonadotrophins and AMH values (z-score mean difference -0.338; 95% CI -0.54, -0.14). When the z-score was adjusted for gonadotrophin dose and AFC, the number of oocytes retrieved was comparable between the two groups (z-score mean difference -0.038; 95% CI -0.34 to 0.27).ConclusionsOvarian response after ovarian stimulation for IVF/ICSI in women with endometriomas is significantly lower than in controls after adjusting for age, gonadotrophin dose and AMH. Dose and protocol selection for ovarian stimulation in patients with endometrioma should be based on AFC rather than AMH, as the latter may be overestimated.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Oocyte Retrieval Ovarian Diseases Ovarian Follicle Ovary Ovulation Induction Adult Age Factors Cross-Sectional Studies Endometriosis Female Fertilization in Vitro Fertilization in Vitro Humans Nomograms Ovarian Diseases Ovarian Follicle Ovarian Reserve Ovarian Reserve Ovary

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