Impact of The Endometrioma on Ovarian Response and Pregnancy Rate in In Vitro Fertilization Cycles

Abstract

Background: Our objective was to evaluate the effect of ovarian endometrioma on ovarian
\nstimulation outcomes in in vitro fertilization cycles (IVF).
\nMaterials and Methods: In this prospective cohort study, we followed 103 patients who
\nunderwent intra-cytoplasmic sperm injection (ICSI) procedures over a 24-months period.
\nThe study group consisted of 47 infertile women with either unilateral or bilateral ovarian
\nendometrial cysts of less than 3 cm. The control group consisting of 57 patients with mild
\nmale factor infertility was candidate for ICSI treatment during the same time period as
\nthe study groups. Both groups were compared for number of oocytes retrieved, grades of
\noocytes, as well as embryo quantity and quality.
\nResults: Our results showed similar follicle numbers, good embryo grades (A or B)
\nand pregnancy rates in the compared groups. However, patients with endometrioma had
\nhigher gonadotropin consumption than the control group. The mean number of retrieved
\noocytes in patients with endometrioma was significantly lower than control group (6.6
\n± 3.74 vs. 10.4 ± 5.25) (p<0.001). In addition, patients with endometrioma had significantly
\nlower numbers of metaphase II (MII) oocytes (5 ± 3.21) than controls (8.2 ± 5.4)
\n(p<0.001). In patients with unilateral endometrioma, there were no significant differences
\nin main outcome measures between normal and involved ovaries in the patients with
\nendometrioma.
\nConclusion: Patients with ovarian endometrioma had poor outcome. They showed poor ovarian
\nresponse with lower total numbers of retrieved oocytes and lower MII oocytes during the
\nstimulation phase; however, it does not affect the total number of embryos transferred per patient,
\nquality of embryos, and pregnancy rate per patient.