Effects of previous ovarian surgery for XXXX on the outcome of assisted reproduction treatment.

@entity1 @entity249 @entity43 @entity46
Endometriosis affects 2-50% of @entity1 at reproductive age. Surgery is an option for treatment, but there is no convincing evidence that it promotes a significant improvement in fertility. Also, the @entity43 might lead to a reduction in the follicular reserve and response to stimulation. Therefore, the aim of this study was to evaluate the effect of previous ovarian surgery for @entity46 on the ovarian response in assisted reproduction treatment cycles and its pregnancy outcome. A total of 61 @entity1 , with @entity249 and previously having undergone ovarian surgery for @entity46 , who had received 74 IVF/intracytoplasmic sperm injection (ICSI) cycles, were studied (study group). A further 74 @entity1 with @entity249 who underwent 77 IVF/ICSI cycles within#10; the same period of time, at the same clinic and without previous ovarian surgery or @entity46 were studied as a control group. @entity1 were matched for age and treatment performed. @entity1 </=35 years with previous ovarian surgery had fewer retrieved oocytes than the @entity1 in the control group (P = 0.049). The number of ampoules used for ovulation induction, duration of folliculogenesis; (days), number of follicles and fertilization rate was similar in both groups. The same was observed for pregnancy rates, with 24 @entity1 (53.3%) having had previous ovarian surgery and 27 (56.2%) in the control group becoming pregnant. @entity1 >35 years with previous ovarian surgery needed more ampoules for ovulation induction (P = 0.017) and had fewer follicles and oocytes than @entity1 in the control group (P = 0.001). Duration of folliculogenesis was similar in both groups, as was fertilization rate. A total of 10 @entity1 achieved pregnancy in the study group (34.5%) and 14 (48.3%) in the control group. Although a lower pregnancy rate was observed in @entity1 who had undergone previous ovarian surgery, this difference was not statistically significant (P = 0.424). In conclusion, ovarian surgery for the treatment of @entity46 reduces the ovarian outcome in IVF/ICSI cycles in @entity1 >35 years old, and might also decrease pregnancy rates. Therefore, for @entity249 @entity1 , non-surgical treatment might be a better option to avoid reduction of the ovarian response.
