Damage to ovarian reserve associated with laparoscopic excision of endometriomas: A quantitative rather than a qualitative injury

Guido Ragni, Ragni G, G. Ragni, Edgardo Somigliana, Benedetti F, Francesca Benedetti, Alessio Paffoni, Walter Vegetti, Liliana Restelli, Restelli L, Pier Giorgio Crosignani, Crosignani PG
American journal of obstetrics and gynecology · 2005 · vol. 193(6) , pp. 1908–1914 · doi:10.1016/j.ajog.2005.05.056 · PMID:16325591 · W2166468991
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Laparoscopic excision of ovarian endometriomas results in quantifiable damage to ovarian reserve, indicating a volume-dependent rather than a type-of-injury-dependent impact.

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Abstract

ObjectiveRetrospective studies suggest that laparoscopic excision of endometriomas is associated with a reduced responsiveness to ovarian hyperstimulation. In this study, we prospectively evaluated ovarian response to hyperstimulation in women selected for in vitro fertilization and intracytoplasmic sperm injection cycles who previously underwent laparoscopic enucleation of a monolateral endometrioma.Study designOperated and contralateral intact ovaries of the same patient were compared in terms of number of follicles, number of oocytes retrieved, fertilization rate, and rate of high-quality embryos.ResultsThirty-eight subjects were included. A reduced number of dominant follicles, oocytes, embryos, and high-quality embryos was observed in the operated gonad. The mean percentage of reduction was 60% (95% confidence interval 38-81%), 53% (95% confidence interval 30-75%), 55% (95% confidence interval 28-81%), and 52% (95% confidence interval 17-87%), respectively. Fertilization rate and rate of good-quality embryos were similar.ConclusionLaparoscopic excision of endometriomas is associated with a quantitative but not a qualitative damage to ovarian reserve.

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Condition tags

endometriosis

MeSH descriptors

Embryo Transfer Endometriosis Ovarian Cysts Ovary Adult Endometriosis Endometriosis Female Gynecologic Surgical Procedures Gynecologic Surgical Procedures Humans Laparoscopy Oocytes Ovarian Cysts Ovarian Cysts Ovarian Follicle Ovary Ovary Ovary Ovary

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