Dear Editor


Recently, we read the article “The effect of surgical management of endometrioma on the IVF/ICSI outcomes when compared with no treatment? A systematic review and metaanalysis” [1]. It was written by M. Nickkho-Amiry as the lead author and published in your journal. We read it with great interest. Together with my research group, I wrote an article on the same topic, based on almost the same material and it was published in Acta Obstetricia et Gynecologica Scandinavica in spring 2017 [2].

In Fig. 2 (Forrest Plots examining outcome measures), in the Forrest plot for “Live Birth Rate/cycle”, the axis may have been named wrongly. A quick calculation shows that number of events out of total events in the “Treated Endometrioma”-group of the Bongioanni study equals roughly 26% (29/112 = 0.258). The events out of total events in the “Non Treated Endometrioma”-group of the same study equals 35% (49/142 = 0.345). This must necessarily mean that the result favors no surgery, since the percentage of live birth rates per cycle is higher. This is in contrast to what the plot shows, as this indicates that the result is in favor of surgery (The square is on the “favors surgery”-side of 1). The same appears to go for all the other studies and actually also includes the Forrest plots of “Clinical Pregnancy/cycle” and “Pregnancy/Cycle”. Based on the results of our own systematic review, it probably will not have any effect on the final result and recommendations, but I hope you will have the opportunity to look into the matter and acquire a comment from the authors.

If it turns out that I have misinterpreted the figure, please accept my apologies, and I will of course take any comment from you or the authors into consideration.


Kind regards,


Jacob Brink Laursen, MD, Senior Registrar

Jeppe Schroll, MD