The Impact of Ovarian Endometrioma(s) on ART Outcomes: Retrospective Case Control Study

Abstract

OBJECTIVE: To compare oocyte yield of women with intact ovarian endometrioma(s) to those without endometrioma undergoing ART. Secondary outcomes were implantation and live birth rates between the two groups.

STUDY DESIGN: Retrospective case-control study was conducted to document eligible cases. A total of 165 women with intact endometrioma(s) (END) were included in the final analysis. Controls were 196 cases with tubal disease as the sole cause of their infertility who underwent ART in the same time period. Cases and controls were matched for age, BMI and serum AMH concentrations. Ovarian stimulation characteristics and pregnancy outcomes including live birth data were documented for both groups.

RESULTS: Despite similar demographic characteristics, significantly longer cycle duration and higher amounts of gonadotropin consumption was observed in END group compared to controls (p<0.001). Significantly lower numbers of retrieved oocytes, mature oocytes and mature oocyte fraction (%, no of retrieved/mature) was detected in END group. There was no statistically significant difference in terms of fertilization, implantation and live birth rate per started cycle among groups. Cycle cancellations were also similar.

CONCLUSION: In women with intact ovarian endometrioma(s) undergoing ART, oocyte quantity, especially mature oocyte yield was hampered. However, adequate number of mature oocytes, successful fertilization and satisfactory implantation rates might be possible contributing to acceptable live births. Further randomized controlled trials of patients with different sizes of endometrioma(s) would be needed to confirm our conclusions.