Obstet Gynecol Sci.  2015 Nov;58(6):481-486. 10.5468/ogs.2015.58.6.481.

Effect of second-line surgery on in vitro fertilization outcome in infertile women with ovarian endometrioma recurrence after primary conservative surgery for moderate to severe endometriosis

• Park H
• Kim CH
• Kim EY
• Moon JW
• Kim SH
• Chae HD
• Kang BM

• KMID: 2314064
• DOI: http://doi.org/10.5468/ogs.2015.58.6.481

Abstract

OBJECTIVE
To evaluate the effect of second-line conservative surgery on in vitro fertilization (IVF) outcome in comparison with IVF without second-line surgery in infertile women with ovarian endometrioma recurrence after primary conservative surgery.
METHODS
In this retrospective cohort study, 121 consecutive IVF/intracytoplasmic sperm injection cycles that were performed after second-line surgery (n=53) or without second-line surgery (control group, n=68) between January 2006 and December 2011 in 121 infertile women with ovarian endometrioma(s) recurrence after primary conservative surgery for moderate to severe endometriosis were included. The two groups were compared in terms of controlled ovarian stimulation and IVF outcomes.
RESULTS
There were no differences in patients' characteristics between the two groups. Total dose and days of gonadotropins administered were significantly higher in the second-line surgery group than in the control group (P<0.001, P=0.008). The numbers of oocytes retrieved, mature oocytes and grade 1 or 2 embryos were significantly lower in the second-line surgery group (P=0.007, P=0.001, P<0.001, respectively). Clinical pregnancy rate per cycle and embryo implantation rate were also significantly lower in the second-line surgery group of 24.5% and 11.8% compared with 48.5% and 25.3% in the control group (P=0.008, P=0.005, respectively).
CONCLUSION
Ovarian response to controlled ovarian stimulation and IVF outcome after second-line surgery is worse than those in IVF cycles without second-line surgery in infertile women with ovarian endometrioma recurrence after primary surgery for moderate or severe endometriosis.

Keyword

Endometrioma recurrence; Endometriosis; Fertilization in vitro; Second-line surgery

MeSH Terms

Cohort Studies
Embryo Implantation
Embryonic Structures
Endometriosis*
Female
Fertilization in Vitro*
Gonadotropins
Humans
Oocytes
Ovulation Induction
Pregnancy
Pregnancy Rate
Recurrence*
Retrospective Studies
Spermatozoa
Gonadotropins

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