The Impact of Laparoscopic Treated Endometrioma on the Live Birth Rate in IVF/ICSI Cycles Compared with Unexplained Infertility: A Prospective Randomized Study

Snezhana Stojkovska; Gligor Dimitrov; Jane Stojkovski; Stefan Saltirovski; Makuli Hadzi-Lega

doi:10.3889/oamjms.2020.4638

Authors

Snezhana Stojkovska Department of IVF and Reproductive Medicine, Remedika, Skopje, Republic of Macedonia
Gligor Dimitrov Department of IVF and Reproductive Medicine, Remedika, Skopje, Republic of Macedonia
Jane Stojkovski Department of IVF and Reproductive Medicine, Remedika, Skopje, Republic of Macedonia
Stefan Saltirovski Kinderwunsch, Kiel, Germany
Makuli Hadzi-Lega Department of IVF and Reproductive Medicine, Remedika, Skopje, Republic of Macedonia

DOI:

https://doi.org/10.3889/oamjms.2020.4638

Keywords:

endometrioma, laparoscopic cystectomy, IVF, ICSI, live birth rate

Abstract

BACKGROUND: It is estimated that 30–70% of patients who undergo treatment for infertility are afflicted with endometriosis.

AIM: The objectives of this study are to evaluate the impact of laparoscopic treated endometrioma compared to unexplained subfertility on the live birth rate in women undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI).

METHODS: This randomized prospective study included 120 women who contacted the department of IVF in the period from 2010 to 2015. Women were divided into two groups according to the findings obtained by laparoscopy. The treated endometrioma group (n = 60) with unilateral ovarian endometriomas and the non-endometriosis group (n = 60) with unexplained infertility undergoing the first cycle of IVF-embryo transfer (IVF-ET) were included in the study. In all participants, ICSI was used and all had fresh embryo transfer per cycle. The primary outcome was to live birth.

RESULTS: Our results demonstrated that clinical pregnancy rates (p = 0.54) and live birth rate (p = 0.63) are similar. The preservation of a good ovarian response to stimulation by gonadotropins after laparoscopic ovarian cystectomy was presented. Laparoscopic cystectomy is followed by good IVF/ICSI outcome into the level expected in women with unexplained subfertility.

CONCLUSION: Therefore, operative treatment is justified by not altering the live birth rate. Additional study is needed to be considered cystectomy before IVF as an effective approach for managing endometriosis-associated infertility.

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