Abstract
ObjectiveTo assess the impact of surgical management of endometrioma on the outcome of assisted reproduction treatment (ART).DesignA systematic review and meta-analysis.SettingDepartment of reproductive medicine at teaching university hospital, UK.PatientsSubfertile women with endometrioma undergoing ART.InterventionsSurgical removal of endometrioma or expectant management.Main outcome measuresClinical pregnancy rate, pregnancy rate, live birth rate, number of oocytes retrieved and number of embryos available and ovarian response to gonadotrophins.ResultsAn extensive search of electronic databases for articles published from inception to September 2016 yielded 11 eligible studies for meta-analysis. Meta-analysis was conducted comparing surgery versus no treatment of endometrioma. There were no significant differences in pregnancy rate per cycle, clinical pregnancy rate and live birth rate between women who underwent surgery for endometrioma and those who did not.ConclusionCurrent evidence suggests that women with endometriosis-related infertility have similar cycle outcomes to other patients going through ART. It is pertinent for clinicians to assess the risks of surgical intervention on ovarian reserve prior to initiating therapy.
Highlights
Endometriosis is a chronic-debilitating disease that affects 5–10% of fertile women [1]
There were no significant differences in clinical pregnancy rate between women who underwent surgery for endometrioma and those who did not per cycle 1.08 [7 studies, OR 1.08] (Fig. 2a2)
Our main finding is that there was no significant difference in pregnancy rate per cycle, clinical pregnancy rate and live birth rate between women who underwent surgery for endometrioma and those who did not
Summary
Endometriosis is a chronic-debilitating disease that affects 5–10% of fertile women [1]. It is characterised by the presence of endometrial-like tissue (glands and stroma) outside the uterus, which induces a chronic inflammatory reaction, scar tissue, and adhesions that may distort a woman’s pelvic anatomy [2]. Further research is necessary to understand this association. The association has been attributed to altered folliculogenesis resulting in reduced quality oocytes [5], mechanical interference with oocyte pickup and transportation [6], exposure to a hostile environment of macrophages, cytokines and vasoactive substances in the peritoneal fluid [7, 8] and anatomical dysfunction of the fallopian tube and ovary [9]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
