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The presence of ovarian endometriomas is associated with a reduced responsiveness to gonadotropins.

Somigliana E, Infantino M, Benedetti F, Arnoldi M, Calanna G, Ragni G

Infertility Unit, Department of Obstetrics, Gynecology and Neonatology, Ospedale Maggiore Policlinico, Mangiagalli and Regina Elena, Milan, Italy. dadosomigliana@yahoo.it

OBJECTIVE: To clarify whether the presence of ovarian endometriomas is associated with a reduced responsiveness to ovarian hyperstimulation. DESIGN: Observational study. SETTING: University teaching hospital. PATIENT(S): Women selected for in vitro fertilization-intracytoplasmic sperm injection (IVF-ICSI) cycles who were found to have unilateral ovarian endometriomas and who did not undergo previous ovarian surgery. INTERVENTION(S): Ovarian hyperstimulation using gonadotropins. MAIN OUTCOME MEASURE(S): Number of codominant follicles (mean diameter >15 mm) in the affected and in the contralateral intact gonads. RESULT(S): Thirty-six patients were enrolled. They underwent 56 IVF-ICSI cycles. The number of codominant follicles in the intact and affected ovaries were 4.0 +/- 2.2 and 3.0 +/- 1.7, respectively (P=.01). This difference corresponded to a mean reduction (95% confidence interval [CI]) of 25% (6%-44%). This deleterious effect was more evident in women with larger cysts, in those with more than one cyst, and in those who were more responsive to ovarian hyperstimulation. CONCLUSION(S): The presence of ovarian endometriomas is associated with a reduced responsiveness to gonadotropins.

Published 4 July 2006 in Fertil Steril, 86(1): 192-6.
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