In vitro fertilization outcome in women with unoperated bilateral endometriomas

The presence of bilateral endometriomas at the time of IVF affects responsiveness to hyperstimulation but does not affect the quality of the oocytes retrieved and the chances of pregnancy.

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Laura Benaglia, M.D., Alfonso Bermejo, M.D., Edgardo Somigliana, M.D., Ph.D., Sonia Faulisi, M.D., Guido Ragni, M.D., Luigi Fedele, M.D., Juan A. Garcia-Velasco, M.D.

Volume 99, Issue 6, Pages 1714-1719, May 2013



To evaluate IVF outcome in women with unoperated bilateral endometriomas.


Multicenter retrospective cohort study.


Two infertility units.


Thirty-nine women with bilateral endometriomas matched to 78 unexposed controls.


Analysis of data from patients who underwent in vitro fertilization (IVF)–intracytoplasmic sperm injection.

Main Outcome measures:

Ovarian responsiveness and oocyte quality.


Responsiveness to ovarian hyperstimulation was significantly reduced in women with bilateral endometriomas. The total number of developing follicles in cases and controls was 9.6 ± 3.3 and 14.1 ± 6.8, respectively. The number of oocytes retrieved was 7.1 ± 3.2 and 9.8 ± 5.5, respectively. Conversely, oocyte retrieval was not hampered by the presence of the ovarian endometriomas. The rate (Interquatile Range-IQR) of oocytes retrieved per total number of developing follicle in cases and controls was 77% (57-88%) and 71% (63-79%), respectively. Moreover, the quality of the retrieved oocytes did not differ. The fertilization rate (IQR) was 67% (56-100%) and 70% (57-100%), respectively. The rate (IQR) of top quality embryos per oocyte used was 33% (25-50%) and 33% (20-43%), respectively. The implantation rate was 22% and 23%, respectively. The clinical pregnancy rate and the delivery rate also did not differ.


Although the presence of bilateral endometriomas at the time of IVF affects responsiveness to hyper-stimulation, the quality of the oocytes retrieved and the chances of pregnancy are not influenced.

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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

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