Impact of ovarian endometrioma on assisted reproduction outcomes

• Published in: Reproductive biomedicine online Vol. 13; no. 3; pp. 349 - 360
• Main Authors: Gupta, Sajal, Agarwal, Ashok, Agarwal, Rishi, de Mola, J Ricardo Loret
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 2006
• Subjects: embryo quality; Endometriosis - complications; Endometriosis - diagnostic imaging; Endometriosis - epidemiology; Endometriosis - therapy; Female; Fertilization in Vitro; Humans; in-vitro fertilization; Infertility, Female - etiology; intracytoplasmic sperm injection; Oocyte Donation; Ovarian Diseases - complications; Ovarian Diseases - diagnostic imaging; Ovarian Diseases - epidemiology; Ovarian Diseases - therapy; ovarian endometrioma; Ovarian Follicle - pathology; Pregnancy; Pregnancy Outcome; Reproductive Techniques, Assisted; retrieved oocytes; Selection Bias; Sperm Injections, Intracytoplasmic; Ultrasonography; embryo quality; ovarian endometrioma; in-vitro fertilization; intracytoplasmic sperm injection; retrieved oocytes
• ISSN: 1472-6483; 1472-6491
• DOI: 10.1016/S1472-6483(10)61439-3

The effects of ovarian endometrioma on fertility outcomes with IVF and embryo transfer have been causally related to poor outcomes. The objective of this meta-analysis was to evaluate the ovarian reserve and ovarian responsiveness to ovarian stimulation and assisted reproduction outcomes in patients with ovarian endometrioma. The odds for clinical pregnancy were not affected significantly in patients with ovarian endometrioma compared with controls, with an overall odds ratio of 1.07 from three studies [95% CI: (0.63, 1.81), P = 0.79]. The overall pregnancy rate was similar with an estimated odds ratio of 1.17 [95% CI: (0.85, 1.60), P = 0.34]. Decreased ovarian responsiveness to ovarian stimulation in patients with ovarian endometrioma may be due to a reduced number of follicles in these patients compared with controls ( P = 0.002). Prospective randomized controlled trials are needed to assess whether surgical treatment versus no surgical treatment improves pregnancy outcomes in patients with ovarian endometrioma undergoing assisted reproduction cycles.