較小子宮內膜異位瘤之誘導排卵結果與正常卵巢並無明顯差異

具有較小子宮內膜異位瘤(<4cm)之病患若不施行手術，其誘導排卵結果並不明顯低於未具有子宮內膜異位瘤之卵巢反應

http://humrep.oxfordjournals.org/content/26/6/1356.full

Figure 1

Number of follicles in ovaries with (grey boxes) and without (white boxes) endometriomas. The total number of follicles and the number of co-dominant follicles was similar in the two groups. The corresponding P-values were P = 0.36 and P = 0.48, respectively.

Unoperated ovarian endometriomas and responsiveness to hyperstimulation

1. Laura Benaglia1, 
2. Roberta Pasin1,2, 
3. Edgardo Somigliana1,*,
4. Paolo Vercellini1,2, 
5. Guido Ragni1 and 
6. Luigi Fedele1,2

+Author Affiliations

1. ¹Department of Obstetrics, Gynecology and Neonatology, Fondazione Cà Granda, Ospedale Maggiore Policlinico, Via M. Fanti, 6, 20122 Milan, Italy
2. ²Università degli Studi di Milano, Milan, Italy

1. *↵Correspondence address. Tel: +39-2-57994303; Fax: +39-2-57994302; E-mail: dadosomigliana@yahoo.it

• Received December 8, 2010.
• Revision received February 6, 2011.
• Accepted March 7, 2011.

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Abstract

BACKGROUND There is a growing consensus that ovarian reserve is reduced after surgical excision of ovarian endometriomas. However, it remains to be fully clarified whether this damage precedes or follows surgery. In order to further elucidate this aspect, we evaluated ovarian responsiveness to hyperstimulation in women selected for IVF with unilateral unoperated endometriomas. The main aim of this study was to compare the number of developing follicles in the affected ovary with that in the contralateral intact gonad as a control.

METHODS Patients selected for IVF who were diagnosed with one or more monolateral endometriomas (diameter <4 cm) and who did not undergo previous ovarian surgery were retrospectively identified. We compared the number of follicles (diameter ≥11 mm) and the number of co-dominant follicles (diameter >15 mm) on the day of hCG administration in the affected and intact ovaries.

RESULTS Among the 84 women selected, the median interquartile range (IQR) number of follicles ≥11 mm in the affected and intact ovaries was 5 (3–7) and 5 (3–8), respectively (P= 0.36). The median (IQR) number of co-dominant follicles in the affected and intact ovaries was 3 (2–4) and 3 (2–5), respectively (P= 0.48). The number of co-dominant follicles was lower in the affected ovary in 36 cases (43%, 95% confidence interval: 32–53%). We also failed to identify any statistically significant difference between the two ovaries when evaluating data according to the number of cysts, their dimension, the dose of gonadotrophins used or the number of oocytes retrieved.

CONCLUSIONS In women selected for IVF, the presence of an endometrioma does not markedly affect responsiveness to hyperstimulation.