Fertility After Ovarian Cystectomy: How Does Surgery Affect IVF/ICSI Outcomes?

Ruth Gomez, Martin Schorsch, Aslihan Gerhold‐Ay, Annette Hasenburg, R. Seufert, Christine Skala
In: Geburtshilfe und Frauenheilkunde · 2019 · vol. 79(01) , pp. 72–78 · doi:10.1055/a-0767-6722 · PMID:30686836 · W2909797271
article OA: hybrid CC0 ⤵ 2 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-10 ⓘ

This study found that ovarian cystectomy did not negatively impact pregnancy or live birth rates in patients undergoing IVF/ICSI compared to controls.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 ⓘ

This retrospective single-center cohort study assessed how laparoscopic ovarian cystectomy versus conservative management for persistent ovarian cysts (≤5 cm; 550 patients, ages 18–40) affected outcomes in the first IVF/ICSI cycle, compared with a large control group of 13,552 patients without ovarian cysts treated in the same period. Patients choosing surgery required fewer retrieved oocytes (MNOR 8.2 ± 5.0) than controls (9.5 ± 5.4), while the non-surgical group required higher gonadotropin stimulation doses than controls but retrieved slightly more oocytes on average. Despite these differences in stimulation and oocyte number, surgical cyst removal was associated with similar clinical pregnancy rate and live birth rate to controls (CPR 34.2 vs. 33.5%; LBR not negatively affected), whereas non-surgical management showed lower pregnancy and live birth rates than controls. Limitations include its retrospective design and that cyst histology was not definitively known at baseline; thus, the paper reports results by management strategy rather than by cyst type, though it used IOTA criteria for classification. This paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via keyword match, with endometrioma mentioned only in the introduction as one example of ovarian cysts.

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Abstract

Abstract Introduction For patients considering undergoing assisted reproductive techniques (ART), many concerns arise when persistent ovarian cysts are found. This large study aimed to determine how ovarian cyst removal affects success rates of IVF/ICSI therapies. Methods 550 patients who underwent an IVF/ICSI treatment between 2002 and 2011 with a persistent ovarian cyst ≤ 5 cm before treatment were analyzed retrospectively. 328 patientsʼ preference was to undergo a laparoscopic cystectomy and 222 patients opted for a conservative management. Control subjects included 13 552 patients undergoing IVF/ICSI at the same period of time without an ovarian cyst. Results After adjusting for age, patients with ovarian cysts without surgery needed a significant higher stimulation dose than the control group (2576.4 vs. 2207.5 IU, p < 0.001). However, on average, they had 1.13 (− 0.25 – 2.01) higher oocyte number retrieved compared to the operated patients (9.0 ± 5.5 vs. 8.2 ± 5.0) (p = 0.012). Patients after surgical cyst removal had a significant lower number of oocytes retrieved (MNOR) in comparison to the control group (8.2 ± 5.0 vs. 9.5 ± 5.4) (p = 0.00). Compared to controls, operated patients had similar clinical pregnancy rate (CPR) (34.2 vs. 33.5%) OR 1.031 (95% CI 0.817 – 1.302) (p = 0.815). Compared to controls, patients without surgery showed significant lower pregnancy rate (34.2 vs. 25,7%) OR 1.428 (95% CI 1.054 – 1.936) (p = 0.002) and lower live birth rate (LBR) (21.9 vs. 13.5%) OR 1.685 (95% CI 1.143 – 2.485) (p = 0.008). Conclusions Ovarian cystectomy did not negatively impact the pregnancy rate or the live birth rate compared to controls.

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