ENDOMETRIOSIS AND INFERTILITY. OPERATION OR ASSISTED REPRODUCTIVE TECHNOLOGIES?

Abstract

The aim of the study was to study the influence of the ovarian endometrioma on the ovarian reserve, the ovarian response in ovarian hyperstimulation, and outcomes of assisted reproductive technologies (ART). Material and methods. The study included 43 infertility patients underwent the surgical treatment of an ovarian endometrioma in the history. During the study, the follicles were counted separately (according to transvaginal ultrasound), eggs and embryos were obtained from the operated and intact ovaries. Results. The number of follicles in the ovary, operated due to endometriosis, is significantly lower than in the contralateral ovary (p = 0.005). The number of ovules punctured from the ovary, operated for endometriosis, is less than the number of ovules obtained from the intact ovary, but the difference does not reach statistical significance (p = 0.07). The number of high-quality embryos obtained from the ovary, operated for endometrioma, is statistically significantly lower than the number of similar embryos obtained from the intact ovary (p = 0.013). Conclusion. According to the conducted study, it can be concluded that the surgical treatment of endometrioma in infertility patients with the need for the implementation of the reproductive function reduces the number of follicles in the operated ovary and, accordingly, does not lead to an improvement in indices of the infertility treatment using ART. At the same time, the very presence of endometrioma is also known to negatively impact on outcomes of ART. Therefore, in infertility patients with the reduced ovarian reserve, individualization of approaches to treatment is extremely important.

Keywords

endometriosis / endometrioma / ovarian reserve / infertility / assisted reproductive technologies / in vitro fertilization (IVF)

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