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?

Arch Gynecol Obstet. 2017 Aug;296(2):263-268. doi: 10.1007/s00404-017-4390-0. Epub 2017 Jun 1.

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; Gynecologists; In vitro fertilization; Laparoscopic cystectomy; Ovarian reserve; Reproductive surgeons.

MeSH terms

  • Adult
  • Case-Control Studies
  • Endometriosis / surgery*
  • Female
  • Fertilization
  • Gynecologic Surgical Procedures / adverse effects
  • Gynecologic Surgical Procedures / standards*
  • Humans
  • Laparoscopy / standards*
  • Oocytes
  • Ovarian Reserve
  • Ovary / pathology
  • Pregnancy
  • Pregnancy Outcome*
  • Pregnancy Rate
  • Retrospective Studies
  • Sperm Injections, Intracytoplasmic
  • Surgeons / standards*