Impact of large ovarian endometriomas on the response to superovulation for in vitro fertilization: A retrospective study

Objective: To assess the response to superovulation for in vitro fertilization (IVF) in patients with unilateral endometriomas with diameter >= 5 cm and in the contralateral healthy ovary. Study design: This retrospective analysis of a prospectively collected database included patients who underwent superovulation for IVF/ICSI cycles and had unoperated single unilateral endometrioma with diameter >= 5 cm and healthy contralateral ovary. The primary outcome of the study was to compare the number of oocyte retrieved in the ovary with the endometrioma and the contralateral healthy ovary. Results: The total number of follicles was lower in ovaries with endometriomas (2.6 +/- 1.3) than in healthy ovaries (4.8 +/- 2.0; p < 0.001). The number of codominant follicles and the total number of oocytes retrieved were lower in ovaries with endometriomas (1.5 +/- 0.9 and 2.0 +/- 1.2) than in the contralateral ovaries (3.7 +/- 1.5 and 4.2 +/- 1.7; p < 0.001, respectively). The number of oocytes retrieved suitable for fertilization was lower in ovaries with endometriomas (1.5 +/- 1.1) than in the healthy ovaries (3.3 +/- 1.5; p < 0.001). The total number of oocytes retrieved and the number of oocytes retrieved suitable for fertilization were lower in ovaries with endometriomas respectively in 21(80.8%) and in 20 (76.9%) cases. The decreased responsiveness to ovarian superovulation was confirmed considering women with ultrasonographic diagnosis of deep infiltrating endometriosis. 30.8% of patients had positive HCG; the pregnancy rate was 23.1%. Conclusion: The presence of large endometriomas (>= 5 cm) at time of IVF significantly decreases the number of oocyte retrieved compared with the contralateral healthy ovaries. (C) 2017 Elsevier B.V. All rights reserved.