Effect of second-line surgery onin vitrofertilization outcome in infertile women with ovarian endometrioma recurrence after primary conservative surgery for moderate to severe endometriosis

Hana Park, Chung-Hoon Kim, Eun‐Young Kim, Eun-Young Kim, Jei-Won Moon, Sung-Hoon Kim, Sung Hoon Kim, Hee Dong Chae, Hee-Dong Chae, Byung-Moon Kang
Obstetrics & gynecology science · 2015 · vol. 58(6) , pp. 481 · doi:10.5468/ogs.2015.58.6.481 · PMID:26623412 · W2175876162
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

Second-line surgery for recurrent ovarian endometriomas worsened IVF outcomes, including lower oocyte and embryo yield and reduced pregnancy and implantation rates compared to IVF without repeat surgery.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This retrospective cohort study evaluated 121 IVF/ICSI cycles in 121 infertile women (ages 28–41) who had ovarian endometrioma(s) recurrence after primary conservative surgery for moderate-to-severe endometriosis, comparing cycles after second-line conservative surgery (n=53) versus IVF without second-line surgery (n=68). Compared with controls, the second-line surgery group received significantly higher gonadotropin doses and stimulation duration, but had significantly fewer oocytes retrieved, fewer mature oocytes, and fewer grade 1–2 embryos, alongside lower clinical pregnancy rate per cycle and lower embryo implantation rate. The authors’ major limitation is that this is a retrospective analysis based on chart review with restricted inclusion/exclusion criteria and without random assignment to surgery versus no surgery. This paper is centrally about endometriosis — it specifically tests whether second-line conservative surgery for recurrent ovarian endometrioma before IVF worsens IVF outcomes compared with proceeding directly to IVF.

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Abstract

OBJECTIVE: To evaluate the effect of second-line conservative surgery on in vitro fertilization (IVF) outcome in comparison with IVF without second-line surgery in infertile women with ovarian endometrioma recurrence after primary conservative surgery. METHODS: In this retrospective cohort study, 121 consecutive IVF/intracytoplasmic sperm injection cycles that were performed after second-line surgery (n=53) or without second-line surgery (control group, n=68) between January 2006 and December 2011 in 121 infertile women with ovarian endometrioma(s) recurrence after primary conservative surgery for moderate to severe endometriosis were included. The two groups were compared in terms of controlled ovarian stimulation and IVF outcomes. RESULTS: There were no differences in patients' characteristics between the two groups. Total dose and days of gonadotropins administered were significantly higher in the second-line surgery group than in the control group (P<0.001, P=0.008). The numbers of oocytes retrieved, mature oocytes and grade 1 or 2 embryos were significantly lower in the second-line surgery group (P=0.007, P=0.001, P<0.001, respectively). Clinical pregnancy rate per cycle and embryo implantation rate were also significantly lower in the second-line surgery group of 24.5% and 11.8% compared with 48.5% and 25.3% in the control group (P=0.008, P=0.005, respectively). CONCLUSION: Ovarian response to controlled ovarian stimulation and IVF outcome after second-line surgery is worse than those in IVF cycles without second-line surgery in infertile women with ovarian endometrioma recurrence after primary surgery for moderate or severe endometriosis.

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endometriosisendometrioma

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