Kiran H, Arikan D C, Kaplanoglu M, Bisak U, Cetin M T
Department of Obstetrics and Gynecology, Kahramanmaras Sutcuimam University, Kahramanmaras, Turkey.
Bratisl Lek Listy. 2012;113(9):544-7. doi: 10.4149/bll_2012_122.
To investigate the effects of ovarian endometrioma on the number of oocytes retrieved for in vitro fertilization (IVF).
The presence of endometrioma may be the most important predictor of a poor reproductive outcome. Literature data suggest that ovarian endometriomas might affect the response to ovarian stimulation and oocyte retrieval.
The present retrospective study evaluates 2,023 women who applied to our center with an infertility complaint. Twenty-nine women with endometriomas (group 1) who were treated with IVF were included in the study. They were compared with 51 women with unexplained infertility (group 2) regarding the number of retrieved oocytes after egg retrieval and number of metaphase II oocytes. The diagnosis of endometrioma was made via ultrasound examination with the identification of low-density cystic masses in the ovaries. The patients underwent a controlled ovarian hyperstimulation (COH) with either the long agonist mini-dose protocol or the multi-dose antagonist protocol.
The incidence of endometrioma in infertile women was found to be 1.4 %. The women's ages ranged between 24 and 45 years, and the duration of their infertility ranged between 12 and 216 months. The endometrioma was bilateral in 24 % of the cases. The mean endometrioma diameter was 26.2±7.3 mm for the right ovary and 23.2±6.1 mm for the left ovary. The average number of retrieved oocytes after egg retrieval in groups 1 and 2 was 12.4±8.3 and 12.2±8.6, respectively. The average number of metaphase II oocytes in groups 1 and 2 was 8.6±6.1 and 9.4±7.3, respectively. The number of retrieved oocytes after egg retrieval and the number of metaphase II oocytes in both endometrioma group and unexplained infertile group were similar (p >0.05).
Endometrioma did not reduce the number of retrieved oocytes in a COH cycle for IVF treatment. However it should be noted that the ovarian response is affected by the size of endometriomas, bilaterality, previous surgeries, recurrence, and the patient's age (Tab. 1, Ref. 31).
探讨卵巢子宫内膜异位囊肿对体外受精（IVF）取卵数量的影响。
子宫内膜异位囊肿的存在可能是生殖结局不良的最重要预测因素。文献数据表明，卵巢子宫内膜异位囊肿可能会影响卵巢刺激反应和取卵情况。
本回顾性研究评估了2023名因不孕前来本中心就诊的女性。研究纳入了29例接受IVF治疗的子宫内膜异位囊肿患者（第1组）。将她们与51例不明原因不孕患者（第2组）在取卵后获得的卵母细胞数量和MII期卵母细胞数量方面进行比较。通过超声检查发现卵巢内低密度囊性肿块来诊断子宫内膜异位囊肿。患者采用长效激动剂小剂量方案或多剂量拮抗剂方案进行控制性卵巢过度刺激（COH）。
发现不孕女性中子宫内膜异位囊肿的发生率为1.4%。女性年龄在24至45岁之间，不孕持续时间在12至216个月之间。24%的病例中子宫内膜异位囊肿为双侧性。右侧卵巢子宫内膜异位囊肿的平均直径为26.2±7.3mm，左侧卵巢为23.2±6.1mm。第1组和第2组取卵后获得的卵母细胞平均数量分别为12.4±8.3和12.2±8.6。第1组和第2组MII期卵母细胞的平均数量分别为8.6±6.1和9.4±7.3。子宫内膜异位囊肿组和不明原因不孕组取卵后获得的卵母细胞数量和MII期卵母细胞数量相似（p>0.05）。
在IVF治疗的COH周期中，子宫内膜异位囊肿并未减少取卵数量。然而，应注意卵巢反应受子宫内膜异位囊肿大小、双侧性、既往手术、复发情况以及患者年龄的影响（表1，参考文献31）。
