Endometriosis negatively impacts the quality of oocyte and ovarian reserve, according to a prospective study in the journal Gynecological Endocrinology. The Russian investigators also found that endometriosis had a harmful and sustained effect on ovarian reserve following ovarian cystectomy.
The study included 130 infertile reproductive-aged women ages 29 to 40 who underwent in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) at the Peoples’ Friendship University of Russia in Moscow in 2018 and 2019. Patients were divided into three groups: surgical treatment for recurrent unilateral endometriomas (n = 50), surgical treatment for nonrecurrent unilateral endometriomas (n = 50) and a control group with tubal factor infertility (n = 30).
In the two treated groups, the number of antral follicles and the number of oocytes obtained via transvaginal puncture of the follicles were significantly fewer in comparison with the control group. For example, the number of antral follicles in the affected ovary in the recurrent unilateral endometriomas group was on average 4.1; in the nonrecurrent unilateral endometriomas group, 5.4; and for the control group at both sides, 12.5. Similarly, the number of antral follicles in the intact ovary before IVF via ultrasound was 7.2 and 7.8, respectively, for the two treated groups.
The total number of oocytes recovered in the recurrent unilateral endometriomas group and the nonrecurrent unilateral endometriomas group, were 8.8 and 9.2, respectively, compared to 10.1 in the control group.
Similarly, the number of high-quality oocytes obtained in the metaphase II (MII) stage for recurrent unilateral endometriomas, nonrecurrent unilateral endometriomas and control were 4.1, 5.2 and 9.6 (control), respectively.
The authors noted that absence of a statistically significant difference (P= 0.005) in the number of obtained oocytes for the two treated groups “is associated with the unilateral location of the endometrioma, as well as the compensatory capabilities of the intact ovary.”
They also observed that the number of oocytes obtained from an ovary containing an endometrial cyst was dramatically lower than for the contralateral ovary without any detected cysts, especially when the endometrioma diameter was greater than 3 cm.