期刊
FERTILITY AND STERILITY
卷 92, 期 1, 页码 75-87出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.fertnstert.2008.05.049
关键词
Endometrioma; surgery; IVF; ovarian response; pregnancy outcome
Objective: To investigate the effect of surgical treatment of endometrioma on pregnancy rate and ovarian response to gonadotrophin stimulation in women undergoing WE Design: A systematic review and meta-analysis. Setting: Tertiary referral center for reproductive medicine. Patient(s): Subfertile women with endometrioma undergoing IVF. Intervention(s): Surgical removal of endometrioma or expectant management. Main Outcome Measure(s): Clinical pregnancy rate and ovarian response to gonadotrophins (number of gonadotrophin ampoules, peak E-2 levels, number of oocytes retrieved, and number of embryos available for transfer). Result(S): A search of three electronic databases for articles published between January 1985 and November 2007 yielded 20 eligible studies. Meta-analysis was conducted for five studies that compared surgery vs. no treatment of endometrioma. There was no significant difference in clinical pregnancy rate between the treated and the untreated groups. Similarly, no significant difference was found between the two groups with regard to the outcome measures used to assess the response to controlled ovarian hyperstimulation with gonadotrophins. Conclusion(s): Collectively the available data in the literature show that surgical management of endometriomas has no significant effect on IVF pregnancy rates and ovarian response to stimulation compared with no treatment. Randomized controlled trials are needed before producing best-practice recommendations on this topic. (Fertil Steril (R) 2009;92:75-87. (C)2009 by American Society for Reproductive Medicine.)
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