Advertisement

Archives of Gynecology and Obstetrics

, Volume 296, Issue 2, pp 263–268 | Cite as

Impact of surgery for endometriomas on pregnancy outcomes following in vitro fertilization-intracytoplasmic sperm injection. Who should be the preferred laparoscopists: gynecologists or reproductive surgeons?

  • He Cai
  • Jing GuanEmail author
  • Huan Shen
  • Hongjing Han
  • Xiaoming Yu
General Gynecology
  • 243 Downloads

Abstract

Objective

To investigate whether laparoscopic excision of ovarian endometriomas pretreated with operation by gynecologists or reproductive surgeons exerts different effects on in vitro fertilization-intracytoplasmic sperm injection results.

Materials and methods

Retrospective case control study. Relevant information was collected from the electronic records of women who underwent IVF/ICSI from 01/01/2013 to 30/12/2015 in our unit. The study group consisted of 35 women who previously had laparoscopic endometrioma excision by reproductive surgeons in our unit; the control group included 36 patients who underwent surgery for endometriomas by gynecologists in our hospital.

Result(s)

There were slightly higher numbers of AFC and higher pregnancy rate in the study group, although differences did not reach statistical significance. For patients over 35 years old, there were more oocyte retrieved, mature oocytes and two pronucei (2PN) in the study group than the control group although observed differences did not reach statistical significance.

Conclusion(s)

Electrocautery is more deleterious on ovarian reserve than hemostatic suture. In procedure of patients who wish to conceive, surgeons should use hemostatic suturing technique preferentially.

Keywords

Endometrioma Reproductive surgeons Gynecologists Laparoscopic cystectomy Ovarian reserve In vitro fertilization 

Notes

Compliance with ethical standards

Funding

None.

Conflict of interest

None of the authors have any conflict of interest associated with the study.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the local ethics committee of Peking University People’s Hospital.

Supplementary material

Supplementary material 1 (MP4 165171 kb)

References

  1. 1.
    Garcia-Velasco JA, Somigliana E (2008) Management of endometriomas in women requiring IVF: to touch or not to touch. Hum Reprod 24:496–501CrossRefPubMedGoogle Scholar
  2. 2.
    Rossi AC, Prefumo F (2016) The effects of surgery for endometriosis on pregnancy outcomes following in vitro fertilization and embryo transfer: a systematic review and meta-analysis. Arch Gynecol Obstet 294:647–655CrossRefPubMedGoogle Scholar
  3. 3.
    Legendre G, Catala L, Morinière C, Lacoeuille C, Boussion F, Sentilhes L, Descamps P (2014) Relationship between ovarian cysts and infertility: what surgery and when? Fertil Steril 101:608–614CrossRefPubMedGoogle Scholar
  4. 4.
    Nakagawa K, Ohgi S, Kojima R, Sugawara K, Ito M, Horikawa T, Irahara M, Saito H (2007) Impact of laparoscopic cystectomy on fecundity of infertility patients with ovarian endometrioma. J Obstet Gynaecol Res 33:671–676CrossRefPubMedGoogle Scholar
  5. 5.
    Aytac PC, Parlakgumus HA, Bolat FA, Cok T, Haydardedeoglu B, Kilicdag EB (2015) Pathological assessment of follicular loss in laparoscopic endometrioma excision: effects of cyst size and surgeon’s experience. Obstet Gynaecol Res 42:264–268CrossRefGoogle Scholar
  6. 6.
    Muzii L, Bellati F, Bianchi A, Palaia I, Manci N, Zullo MA, Angioli R, Panici PB (2005) Laparoscopic stripping of endometriomas: a randomized trial on different surgical techniques. Part II: pathological results. Hum Reprod 20:1987–1992CrossRefPubMedGoogle Scholar
  7. 7.
    Yu HT, Huang HY, Soong YK, Lee CL, Chao A, Wang CJ (2010) Laparoscopic ovarian cystectomy of endometriomas: surgeons’ experience may affect ovarian reserve and live-born rate in infertile patients with in vitro fertilization-intracytoplasmic sperm injection. Eur J Obstet Gynecol Reprod Biol 152:172–175CrossRefPubMedGoogle Scholar
  8. 8.
    Canis M, Pouly JL, Tamburro S, Mage G, Wattiez A, Bruhat MA (2001) Ovarian response during IVF-embryo transfer cycles after laparoscopic ovarian cystectomy for endometriotic cysts of >3 cm in diameter. Hum Reprod 16:2583–2586CrossRefPubMedGoogle Scholar
  9. 9.
    American Society for Reproduction Medicine (1997) Revised American Society for Reproductive Medicine classification of endometriosis: 1996. Fertil Steril 67:817–821CrossRefGoogle Scholar
  10. 10.
    Urman B, Alper E, Yakin K, Oktem O, Aksoy S, Alatas C, Mercan R, Ata B (2013) Removal of unilateral endometriomas is associated with immediate and sustained reduction in ovarian reserve. Reprod Biomed Online 27:212–216CrossRefPubMedGoogle Scholar
  11. 11.
    Sahin C, Akdemir A, Ergenoglu AM, Ozgurel B, Yeniel AO, Taskiran D, Sendag F (2017) Which should be the preferred technique during laparoscopic ovarian cystectomy. Reprod Sci 24:393–399CrossRefPubMedGoogle Scholar
  12. 12.
    Muzii L, Miller CE (2011) The singer, not the song. J Minim Invasive Gynecol 18:666–667CrossRefPubMedGoogle Scholar
  13. 13.
    Angioli R, Muzii L, Montera R, Damiani P, Bellati F, Plotti F, Zullo MA, Oronzi I, Terranova C, Panici PB (2009) Feasibility of the use of novel matrix hemostatic sealant (FloSeal) to achieve hemostasis during laparoscopic excision of endometrioma. J Minim Invasive Gynecol 16:153–156CrossRefPubMedGoogle Scholar
  14. 14.
    Donnez J, Lousse JC, Jadoul P, Donnez O, Squifflet J (2010) Laparoscopic management of endometriomas using a combined technique of excisional (cystectomy) and ablative surgery. Fertil Steril 94:28–32CrossRefPubMedGoogle Scholar
  15. 15.
    Keresztúri A, Kozinszky Z, Daru J, Pásztor N, Sikovanyecz J, Zádori J, Márton V, Koloszár S, Szöllősi J, Németh G (2015) Pregnancy rate after controlled ovarian hyperstimulation and intrauterine insemination for the treatment of endometriosis following surgery. Biomed Res Int 2015:282–301CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • He Cai
    • 1
  • Jing Guan
    • 1
    Email author
  • Huan Shen
    • 1
  • Hongjing Han
    • 1
  • Xiaoming Yu
    • 1
  1. 1.Obstetrics and Gynecology Department, Peking University People’s HospitalBeijingChina

Personalised recommendations