The effect of surgical management of endometrioma on the IVF/ICSI outcomes when compared with no treatment? A systematic review and meta-analysis.

OBJECTIVE

To assess the impact of surgical management of endometrioma on the outcome of assisted reproduction treatment (ART).

DESIGN

A systematic review and meta-analysis.

SETTING

Department of reproductive medicine at teaching university hospital, UK.

PATIENTS

Subfertile women with endometrioma undergoing ART.

INTERVENTIONS

Surgical removal of endometrioma or expectant management.

MAIN OUTCOME MEASURES

Clinical pregnancy rate, pregnancy rate, live birth rate, number of oocytes retrieved and number of embryos available and ovarian response to gonadotrophins.

RESULTS

An extensive search of electronic databases for articles published from inception to September 2016 yielded 11 eligible studies for meta-analysis. Meta-analysis was conducted comparing surgery versus no treatment of endometrioma. There were no significant differences in pregnancy rate per cycle, clinical pregnancy rate and live birth rate between women who underwent surgery for endometrioma and those who did not.

CONCLUSION

Current evidence suggests that women with endometriosis-related infertility have similar cycle outcomes to other patients going through ART. It is pertinent for clinicians to assess the risks of surgical intervention on ovarian reserve prior to initiating therapy.