Weigh the pros and cons to ovarian reserve before stripping ovarian endometriomas prior to IVF-ICSI: A meta-analysisReport as inadecuate




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Purpose

To explore the effects of conservative surgery for endometriomas on ovarian responsiveness during assisted reproductive technology ART and provide reproductive and gynecological doctors with a more reliable reference program for the treatment of endometriomas.

Methods

A literature search was performed by searching the PubMed, Embase, Cochrane Library, Web of Science and Science Direct databases. Studies with inter- and intra-patient comparisons of ovarian responses and oocyte quality between operated and unoperated ovaries and that met the inclusion criteria were retrieved, and the data from the outcome measures were extracted and pooled for this meta-analysis.

Results

Twenty-one published studies 2649 ART cycles were included. The total amount of gonadotropin Gn used inverse variance IV:0.48; 95% confidence interval CI: 0.13, 1.82, P = 0.0007 was significantly increased in the women with endometriomas who had a history of cystectomy. The estrogen E level on the day of hCG administration IV: -0.29; 95% CI: -0.41 -0.17, P<0.00001, the number of mature or dominant follicles IV: -1.17; 95% CI: -1.51 -0.82, P<0.00001 and the total number of oocytes retrieved IV: -1.78; 95% CI: -2.38 -1.17, P<0.00001 were significantly decreased in the women with endometriomas who had a history of cystectomy. The duration of stimulation IV: 0.02; 95% CI: -0.09, 0.13, P = 0.77, the total number of formed embryos IV: -0.06; 95% CI: -0.17, 0.04, P = 0.25, the pregnancy rateIV:0.98;95%CI0.82,1.18, P = 0.83 and the live birth rateIV:0.93;95%CI0.70,1.23, P = 0.61were not statistically different between the two groups. Similar intra-patient results were found in the number of mature or dominant follicles IV: -0.88; 95% CI: -1.25 -0.52, P<0.00001 and the total number of oocytes retrieved IV: -3.48; 95% CI: -4.77 -2.19, P<0.00001.

Conclusion

ART might be a better therapeutic method for ovarian endometrioma-related infertility than cystectomy.



Author: Xin Tao , Lei Chen , Shuqi Ge , Lisi Cai

Source: http://plos.srce.hr/



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