The Impact of laparoscopic surgery of peritoneal endometriosis and endometrioma on the outcome of ICSI cycles

Abstract

Our objective was to assess the role of laparoscopic removal of ovarian endometriomas and ablation of peritoneal endometriosis on the outcome of intracytoplasmic sperm injection (ICSI) - Embryo Transfer cycles by comparing with the results of patients with untreated endometriomas and tubal factor without underlying endometriosis confirmed by laparoscopy. For this purpose, between 2002 and 2015, outcomes of 257 ICSI cycles of 150 patients, including 91 cycles of 48 patients in minimal endometriosis, 57 cycles of 25 patients in endometrioma removal, 65 cycles of 53 patients in non-operated endometrioma, and 44 cycles of 24 patients in tubal factor groups were retrospectively analyzed. Basal ovarian reserve was significantly lower, mean starting and total gonadotropin consumption was significantly higher, and mean serum E2 on the day of hCG injection, number of dominant follicles, number of retrieved total, and MII oocytes were all significantly lower in the endometrioma cystectomy group. Fertilization and embryo cleavage rates were also significantly the lowest in the endometrioma cystectomy group, whereas clinical pregnancy and live birth rates were comparable among all groups. The number of transferred embryos and duration of infertility were the most significant predictors of clinical pregnancy and live birth. Basal antral follicle count was also significant in predicting live birth.

Association Between Endometriosis and Preterm Birth in Women With Spontaneous Conception or Using Assisted Reproductive Technology: A Systematic Review and Meta-Analysis of Cohort Studies

“…Some large-scale studies showed a prevalence of endometriosis in 25% to 40% of infertile women, 5,6 as well as low basal ovarian reserve, low fertility rate, and embryo cleavage. 7 In addition, the pro-inflammatory and angiogenic factors in the ectopic endometrium may contribute to abnormal placentation 2,8 and to develop major obstetrical complications including activation of the mechanisms involved in preterm birth (PB) 1,2,9 ; newborns of these women need more frequent neonatal intensive care unit admissions. 10 However, other studies reported that complications of endometriosis are rare and have no major negative effect on pregnancy outcomes.…”

The impact of different etiologies of diminished ovarian reserve on pregnancy outcome in IVF-ET cycles

“…Guler et al reported that cycle cancellation was significantly higher and clinical pregnancy per cycle and per embryo transfer was significantly lower in the operated endometrioma group in comparison to patients with intact endometriomas, and they concluded that laparoscopic endometrioma cystectomy may worsen IVF/ ICSI outcomes by decreasing ovarian reserve and the quality of oocytes and embryos [20].…”

Different Etiological Aspects of Diminished Ovarian Reserve Impact on Clinical Outcomes of ICSI Cycles

“…Decreased ovarian reserve, is great clinical challenge in reproductive medicine everyday practice of assisted reproduction. Cases suffering from reduced ovarian reserve however different etiologies could have various impact and influences on the IVF/ ICSI clinical outcomes [11][12][13].…”

“…A prior research team of investigators have compared in analytical manner the IVF live birth rates in cases having diminished ovarian reserve issues after performance of ovarian cystectomy for endometrioma with cases having idiopathic issues of diminished ovarian reserve revealing a statistically significantly higher rate of fertilization rate and mean number of embryos but a reduced rates of clinical pregnancy in cases that had an endometrioma excision operative procedure [10,12,13].…”