Data di Pubblicazione:
2006
Citazione:
Should endometriomas be treated before IVF-ICSI cycles? / E. Somigliana, P. Vercellini, P. Viganò, G. Ragni, P.G. Crosignani. - In: HUMAN REPRODUCTION UPDATE. - ISSN 1355-4786. - 12:1(2006), pp. 57-64.
Abstract:
The laparoscopic excision of ovarian endometriomas appears to increase the chances of spontaneous conception, but
the value of this treatment in women selected for IVF–ICSI cycles is debated. Studies recruiting women with unilateral
disease and comparing ovarian responsiveness in the affected and contralateral intact gonads indicate that excision
of endometriomas is associated with a quantitative damage to ovarian reserve. There are no randomized trials
comparing laparoscopic excision to expectant management before IVF–ICSI cycles. The idea that surgery increases
IVF pregnancy rates is not supported by the available evidence. However, the chance of conception is not the only
issue that has to be considered. Some potential drawbacks are associated with both therapeutical strategies. Specifically,
costs and hazard of surgical complications support expectant management whereas oocyte retrieval risks, the
possibility of missing occult malignancy and endometriosis progression due to ovarian stimulation would favour surgical
treatment. Alternative therapeutical options include medical treatment and ultrasound-guided aspiration.
Whereas prolonged GnRH agonist down-regulation may be beneficial, data on ultrasound aspiration are more
controversial.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
endometrioma ; endometriosis ; IVF ; laparoscopy ; ovarian reserve
Elenco autori:
E. Somigliana, P. Vercellini, P. Viganò, G. Ragni, P.G. Crosignani
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