Ovarian response during IVF–embryo transfer cycles after laparoscopic ovarian cystectomy for endometriotic cysts of &gt;3 cm in diameter

Canis, Michel; Pouly, Jean Luc; Tamburro, S.; Mage, G.; Wattiez, Arnaud; Bruhat, M. A.

doi:10.1093/humrep/16.12.2583

Cited by 168 publications

(81 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This area is revealed by lyses of adhesions between the ovary and the adjacent broad ligament, leading to characteristic 'chocolate fluid' evacuating from the cyst. The excision by scissors of area A allows the surgeon to identify a cleavage plane close to the cyst wall, which may be followed without significant bleeding (area B; Canis et al, 2001). Where adhesions are revealed in the cleavage plane, they should be coagulated and cut, so as not to strip the ovarian cortex.…”

Section: Methodsmentioning

confidence: 99%

Direct proportional relationship between endometrioma size and ovarian parenchyma inadvertently removed during cystectomy, and its implication on the management of enlarged endometriomas

Roman¹,

Tarta²,

Pura³

et al. 2010

Human Reproduction

120

View full text Add to dashboard Cite

background: The aim of this study was to estimate whether or not the size of an endometrioma is related to the thickness of the ovarian parenchyma inadvertently excised along with the cyst wall.methods: We performed a retrospective study including 35 women who had undergone endometrioma cystectomy, using an ovarian tissue sparing procedure. In total 38 specimens were studied by three pathologists as three women presented bilateral localizations, and all cyst diameters measured at least 30 mm. For each endometrioma, serial sections were performed, and on each section four different sites were randomly chosen to measure the thickness of glandular epithelium and stroma, of subjacent fibrosis, depending on the cyst, and of the ovarian parenchyma removed with the cyst. The diameter of the ovary was measured preoperatively either by MRI or ultrasound, and the area of the internal wall was then calculated. The relationships between the mean thickness of ovarian parenchyma removed and the variables were estimated and a multiple regression model identified independent predictors for ovarian parenchyma thickness.results: Adjacent ovarian tissue was found in 37 cases (97%). The mean thickness of ovarian tissue removed was 1173 + 711 mm and that of the cyst wall was 851 + 499 mm. The thickness of the ovarian parenchyma removed presented a direct proportional relationship with cyst diameter (P ¼ 0.015), and consequently with cyst wall area (P ¼ 0.032). This relationship with cyst diameter was independent after adjustment on other variables (P ¼ 0.032).conclusion: Endometrioma cystectomy even though performed with an accurate surgical technique leads to significant ovarian tissue removal, the thickness of which increases proportionally with cyst diameter.

show abstract

Section: Methodsmentioning

confidence: 99%

Direct proportional relationship between endometrioma size and ovarian parenchyma inadvertently removed during cystectomy, and its implication on the management of enlarged endometriomas

Roman¹,

Tarta²,

Pura³

et al. 2010

Human Reproduction

120

View full text Add to dashboard Cite

show abstract

“…17 Canis et al and Marconi et al found no effect on ovarian response in IVF after cystectomy. 18,19 But, there are many other trials that indicate that cystectomy has a bad influence in the subsequent ovarian responsiveness. As Hart et al concluded, excisional surgery of endometriomas results in a more favorable outcome than drainage and ablation in terms of recurrence, pain symptoms, subsequent spontaneous pregnancy in previously sub-fertile women, and ovarian response to stimulation.…”

Section: Fenestration and Ablation (Fulguration Or Vaporization)mentioning

confidence: 99%

A review article on ovarian cystectomy in endometriomas by laparoscopy

Yadav

Patel

2017

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

Endometrioma is one of the most frequent adnexal masses in the reproductive population. Medical therapy is inefficient and cannot be recommended in the management of ovarian endometriomas. The general consensus is that ovarian endometriomas larger than 4 cm should be removed, both to reduce pain and to improve spontaneous conception rates. The removal of ovarian endometriomas can be difficult, as the capsule is often densely adherent. While the surgical treatment of choice is surgical laparoscopy, for conservative treatment, the preferred method is modified combined cystectomy. Cystectomy can be destructive for the ovary, whereas ablation may be incomplete, with a greater risk of recurrence.

show abstract

“…Furthermore, they pointed that removing endometrioma did not affect the quality of oocyte in IVF cycle as an evidence of no additional advantage of surgery in ART cycle [27]. On the other hand, some investigators did not support the same opinion [28][29][30][31]. It is clear that considerable surgical expertise is requied to decrease ovarian damage and avoid incomplete surgery [32].…”

Section: Management Of Infertilitymentioning

confidence: 99%

Management of Endometriosis-Associated Infertility

2014

J Androl Gynaecol

View full text Add to dashboard Cite

Endometriosis is a common, chronic disease. Patients typically present with pelvic pain, infertility, and/or an adnexal mass. Results from the limited number of studies that have been published indicate that the true prevalence of endometriosis, along with the associated infertility, has been increasing. Debates about infertility management arise from the contradiction between the contraceptive nature of medical treatments for endometriosis and the unpredictable ovarian reserve after surgery. There is moderate quality evidence that surgery increases clinical pregnancy rate and live birth in minimal to mild endometriosis. However, insufficient evidences which supports the effect of surgery in moderate to severe endometriosis in term of subfertility. On this basis, artificial reproductive technologies have been become the most efficient way of overcoming endometriosisassociated infertility, particularly in stage III/IV endometriosis. The objective of this paper is to review recent trends in endometriosis, from the pathophysiology of the disease to the management of infertility.endometriosis and infertility and to assess the current approaches and management modalities used for infertile women with endometriosis. PathophysiologyAs previously mentioned, how endometriosis contributes to infertility remains controversial. However, there are a few hypotheses that describe the pathophysiology of endometriosis-associated infertility when the endometriotic lesion is located in the pelvic cavity, ovary, or uterus [8]. Distorted Pelvic AnatomyPelvic adhesions that develop as a consequence of endometriosis can interfere with ovulation, transport of the oocyte or ovum, and pick-up by the fimbriae. The oviducts may be patent bilaterally, but existing adhesions around the adnexa can interrupt the dynamic movements of the fimbriae that are necessary for oocyte uptake [9]. Altered Peritoneal MilieuThe chronic inflammatory status of the pelvic cavity in endometriosis patients has been recognized for decades. This inflammation is accompanied by increased infiltration of macrophages in the pelvic fluid. The pathophysiology has not been well-described, but increased recruitment of immune cells and dysregulated apoptosis of endometrial cells present in the lesion are thought to be contributing factors. Additional support for this hypothesis arises from the observation that in addition to the macrophages, inflammatory cytokines, and prostaglandins, chemokines stimulate and aggregate monocytes and granulocytes. RANTES [10], monocyte inflammatory protein-1 [11,12] IntroductionEndometriosis is a disease characterized by ectopic endometrial glands and stromal tissue external to the uterine cavity. The prevalence of the disease has been reported to be 5-10% in women of reproductive age, 20-30% in women diagnosed with infertility, and 40-60% in women with chronic pelvic pain [1]. Fecundity, the probability of giving live birth in a menstrual cycle, has been shown to be 0.02-0.1 per month in women with endometriosis, but is 0.15-0.2 ...

show abstract

Ovarian response during IVF–embryo transfer cycles after laparoscopic ovarian cystectomy for endometriotic cysts of >3 cm in diameter

Cited by 168 publications

References 22 publications

Direct proportional relationship between endometrioma size and ovarian parenchyma inadvertently removed during cystectomy, and its implication on the management of enlarged endometriomas

Direct proportional relationship between endometrioma size and ovarian parenchyma inadvertently removed during cystectomy, and its implication on the management of enlarged endometriomas

A review article on ovarian cystectomy in endometriomas by laparoscopy

Management of Endometriosis-Associated Infertility

Contact Info

Product

Resources

About