The success of various endometrioma treatments in infertility: A systematic review and meta‐analysis of prospective studies

Alborzi, Saeed; Sorouri, Ziba Zahiri; Askari, Elham; Poordast, Tahereh; Chaman‐Ara, Kefayat

doi:10.1002/rmb2.12286

Cited by 44 publications

(24 citation statements)

References 49 publications

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“…If considering only spontaneous conception, in our study the postoperative pregnancy rate for all infertile patients was 45.3%, which is consistent with data reported in the recent meta-analysis by Alborzi et al [28]. Moreover, our results showed slightly lower rates of spontaneous pregnancy after CO 2 laser vaporization compared to cystectomy (35.9% vs 55.5%, respectively); however, this finding did not reach statistical significance.…”

Section: Figsupporting

confidence: 88%

“…Noteworthy, our rates are also higher compared with those reported for patients with untreated endometrioma undergoing ART as a first approach (pregnancy rate: 35.1%) [27]. These results support other published data [28,29] and suggest that surgery is a good option in infertile women with endometrioma to improve their chances to get pregnant. These findings are likely related to the operator expertise in endometriosis surgery in our study that performed the procedures and to the improvement of techniques and instrumentation over time.…”

Section: Figsupporting

confidence: 85%

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Fertility Outcome after CO2 Laser Vaporization versus Cystectomy in Women with Ovarian Endometrioma: A Comparative Study

Candiani¹,

Ferrari²,

Bartiromo³

et al. 2021

Journal of Minimally Invasive Gynecology

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To assess the postoperative likelihood of conception in patients with endometriomas managed by either CO 2 laser vaporization or cystectomy. Design: A retrospective study with prospective recording of data. Setting: University hospital. Patients: One hundred and forty-two patients with symptomatic endometriomas. Interventions: Patients underwent a standardized laparoscopic stripping technique (Group 1) or cyst vaporization with CO 2 fiber laser (Group 2). Patients wishing to become pregnant were allowed to attempt a spontaneous conception after surgery. If spontaneous conception failed, patients were referred for in vitro fertilization (IVF). Measurements and Main Results: The primary objective was to compare pregnancy rates between the 2 groups. The secondary objective was the identification of independent predictors of pregnancy. Thirty-nine women in Group 1 (53.4%) and 39 women in Group 2 (56.5%) desired to conceive after surgery. Three patients (7.7%) in Group 1 became pregnant following donor-IVF and were excluded. Pregnancies were recorded in 72.2% of patients treated with cystectomy and in 74.3% of those managed with CO 2 fiber laser (p = .83). Twenty patients (55.6%) in Group 1 and 14 patients (35.9%) in Group 2 conceived spontaneously (p = .08). Among patients who failed spontaneous conception, 21 patients (28%) achieved pregnancy through IVF (Group 1: n = 6, 16.7%; Group 2: n = 15, 38.5%; p = .08). Twenty patients (26.7%) never became pregnant. Age at the time of surgery (odds ratio (OR) = 0.86; 95% Confidence intervals (CI): 0.78−0.96, p = .002) and duration of infertility (OR=0.80; 95% CI: 0.69−0.92, p = .006) were identified as independent indicators for pregnancy. Conclusion: CO 2 laser-treated endometrioma is associated with pregnancy rates equal to those observed after cystectomy and favorable IVF outcomes. The one step CO 2 fiber laser technique may represent a viable alternative to cystectomy. Journal of Minimally Invasive Gynecology (2021) 28, 34−41.

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Section: Figsupporting

confidence: 88%

Section: Figsupporting

confidence: 85%

Fertility Outcome after CO2 Laser Vaporization versus Cystectomy in Women with Ovarian Endometrioma: A Comparative Study

Candiani¹,

Ferrari²,

Bartiromo³

et al. 2021

Journal of Minimally Invasive Gynecology

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“…There was no difference among groups. However, the success rate of surgery was higher (43.8%, confidence interval (CI): 22.5–66.4), while the success rate of only ART was the lowest (32%, CI: 15.0–52.0) [ 55 ].…”

Section: Resultsmentioning

confidence: 99%

Impact of Surgical Management of Endometrioma on AMH Levels and Pregnancy Rates: A Review of Recent Literature

Pais

Flagothier

Tebache

et al. 2021

JCM

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Ovarian endometrioma are found in up to 40% of women with endometriosis and 50% of infertile women. The best surgical approach for endometrioma and its impact on pregnancy rates is still controversial. Therefore, we conducted a literature review on surgical management of ovarian endometrioma and its impact on pregnancy rates and ovarian reserve, assessed by anti-Müllerian hormone (AMH) serum levels. Ovarian cystectomy is the preferred technique, as it is associated with lower recurrence and higher spontaneous pregnancy rate. However, ablative approaches and combined techniques are becoming more popular as ovarian reserve is less affected and there are slightly higher pregnancy rates. Preoperative AMH level might be useful to predict the occurrence of pregnancy. In conclusion, AMH should be included in the preoperative evaluation of reproductive aged women with endometriosis. The surgical options for ovarian endometrioma should be individualized. The endometrioma ablation procedure seems to be the most promising treatment.

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“… 12 However, studies have shown that a successful outcome can be achieved after surgery. 23 , 24 Because endometriosis in each woman was located at multiple regions, it affected the reproductive function (fecundity). However, it was difficult to measure this reproductive outcome in this condition, and hence the reproductive outcome was not measured in the current study.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Laparoscopic Partial Cystectomy of Bladder Endometriosis: A Report of 18 Thai Women

Lertvikool

Tingthanatikul

Hongsakorn

et al. 2021

Women's Health Reports

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Aim: To determine the outcomes of laparoscopic partial cystectomy (LPC) for bladder endometriosis (BE). Methods: This was a retrospective study using medical records of women who underwent LPC for BE between January 2009 and December 2017. Demographic characteristics, surgical findings, including surgical site and size of the bladder lesion, endometriosis at other locations, and pre- and postoperative hormonal treatment data were collected. Results: We analyzed data of 18 women with full-thickness BE. The patients had a mean age of 34 (range, 26–45) years and body mass index of 21.6 (range, 16.1–25) kg/m 2 . All women had dysmenorrhea. Other symptoms noted include dysuria, gross hematuria, and infertility. BE with a mean diameter of 2.7 cm (range, 1–5) was most commonly found at the posterior wall of the bladder (94.4%). Peritoneal endometriosis (94.4%), endometrioma (33.3%), and deep endometriotic nodules (22.2%) in the posterior compartment were also found. No surgical complications were observed. Postoperative hormonal treatment was administered to 14 (77.8%) patients. All symptoms improved after the surgery. No recurrence was found after 30 (range, 12–74) months of follow-up. Conclusion: LPC is an effective treatment option for BE.

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The success of various endometrioma treatments in infertility: A systematic review and meta‐analysis of prospective studies

Cited by 44 publications

References 49 publications

Fertility Outcome after CO2 Laser Vaporization versus Cystectomy in Women with Ovarian Endometrioma: A Comparative Study

Fertility Outcome after CO2 Laser Vaporization versus Cystectomy in Women with Ovarian Endometrioma: A Comparative Study

Impact of Surgical Management of Endometrioma on AMH Levels and Pregnancy Rates: A Review of Recent Literature

Outcomes of Laparoscopic Partial Cystectomy of Bladder Endometriosis: A Report of 18 Thai Women

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