Surgical diminished ovarian reserve after endometrioma cystectomy versus idiopathic DOR: comparison of in vitro fertilization outcome

• DOI: 10.1093/humrep/dev029
• Publication Date: 2015-03-05T01:33:20Z
• Authors: A. Roustan; J. Perrin; M. Debals-Gonthier; O. Paulmyer-Lacroix; A. Agostini; B. Courbiere
• Keywords: Ovarian Reserve; Live birth; Controlled ovarian hyperstimulation

Does the live birth rate after IVF depend on etiology of diminished ovarian reserve (DOR)? outcome and are significantly impaired in women with DOR caused by a previous cystectomy for endometrioma compared idiopathic DOR. The safety surgical treatment endometriomas is being discussed terms damage to reserve. Several studies have reported poor response controlled stimulation consecutive an tubal factor infertility. Retrospective case–control study conducted aged under 40 treated our Reproductive Medicine Center between January 2010 2014 defined anti-Müllerian hormone level <2 ng/ml. Two groups patients were selected: group A included diagnosed cystectomy(s) endometrioma(s), B In each group, subgroups ‘poor responders’, based ESHRE criteria (‘Bologna criteria’), been established. total 51 matched 116 B, representing respectively 125 243 cycles. Among them, 39 78 validated strictly Bologna criteria, 99 189 cycles, respectively. Each patient underwent hyperstimulation fresh embryo transfer. Primary end-point was rate. Secondary end-points number retrieved oocytes, fertilization rate, implantation clinical pregnancy spontaneous abortion cycle cancelation Significantly lower (11.2% versus 20.6% P = 0.02) (7.2 16.9% respectively, 0.01) rates per assessed B. same results obtained subgroup analysis (9.1 20.1%, 0.016) (5.1 15.3%, 0.001) Patients required higher gonadotrophins doses (2881 IU ± 1111 2526 795, 0.005), longer (10.6 Days 2.8 9.9 2.4, 0.019) (12 6.2%, 0.05). Despite mean oocytes similar (5.4 3.1 5.1 3.2, NS), (65.7 47.2%, < 0.001), showed 13.5%, 0.03). Abortion ectopic multiple both groups. Data collected retrospectively using database Department. Sample size relatively small but provides statistically significant evidence that chances success decreased endometrioma. Further larger series needed confirm these findings. To knowledge, this first evaluating endometrioma(s) addition risk damaging reserve, we hypothesize surgery would not qualitative benefits authors no competing interests declare.