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Cited by 375Endometriosis Research and TreatmentReproductive Health and TechnologiesReproductive Biology and Fertility

The impact of endometrioma on IVF/ICSI outcomes: a systematic review and meta-analysis

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Hamdan, M., Dunselman, G., Li, T.C., Cheong, Y.·2015·Human Reproduction Update
DOI 10.1093/humupd/dmv035
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Abstract

BACKGROUND: Endometriosis is a disease known to be detrimental to fertility. Women with endometriosis, and the presence of endometrioma, may require artificial reproductive techniques (ART) to achieve a pregnancy. The specific impact of endometrioma alone and the impact of surgical intervention for endometrioma on the reproductive outcome of women undergoing IVF/ICSI are areas that require further clarification. The objectives of this review were as follows: (i) to determine the impact of endometrioma on IVF/ICSI outcomes, (ii) to determine the impact of surgery for endometrioma on IVF/ICSI outcome and (iii) to determine the effect of different surgical techniques on IVF/ICSI outcomes. METHODS: We performed a systematic review and meta-analysis examining subfertile women who have endometrioma and are undergoing IVF/ICSI, and who have or have not had any surgical management for endometrioma before IVF/ICSI. The primary outcome was live birth rate (LBR). Our secondary outcomes were clinical pregnancy rate (CPR), mean number of oocyte retrieved (MNOR), miscarriage rate (MR), fertilization rate, implantation rate, antral follicle count (AFC), total stimulating hormone dose, and any rates of adverse effects such as cancellation and associated complications during the IVF/ICSI treatment. RESULTS: We included 33 studies for the meta-analysis. The majority of the studies were retrospective (30/33), and three were RCTs. Compared with women with no endometrioma undergoing IVF/ICSI, women with endometrioma had a similar LBR (odds ratio [OR] 0.98; 95% CI [0.71, 1.36], 5 studies, 928 women, I(2) = 0%) and a similar CPR (OR 1.17; 95% CI [0.87, 1.58], 5 studies, 928 women, I(2) = 0%), a lower mean number of oocytes retrieved (SMD -0.23; 95% CI [-0.37, -0.10], 5 studies, 941 cycles, I(2) = 37%) and a higher cycle cancellation rate compared with those without the disease (OR 2.83; 95% CI [1.32, 6.06], 3 studies, 491 women, I(2) = 0%). Compared with women with no surgical treatment, women who had their endometrioma surgically treated before IVF/ICSI had a similar LBR (OR 0.90; 95% CI [0.63, 1.28], 5 studies, 655 women, I(2) = 32%), a similar CPR (OR 0.97; 95% CI [0.78, 1.20], 11 studies, 1512 women, I(2) = 0%) and a similar mean number of oocytes retrieved (SMD -0.17; 95% CI [-0.38, 0.05], 9 studies, 810 cycles, I(2) = 63%). CONCLUSIONS: Women with endometrioma undergoing IVF/ICSI had similar reproductive outcomes compared with those without the disease, although their cycle cancellation rate was significantly higher. Surgical treatment of endometrioma did not alter the outcome of IVF/ICSI treatment compared with those who did not receive surgical intervention. Considering that the reduced ovarian reserve may be attributed to the presence of endometrioma per se, and the potential detrimental impact from surgical intervention, individualization of care for women with endometrioma prior to IVF/ICSI may help optimize their IVF/ICSI results.

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  • The presence of endometriomas does not alter ART results.

    “As mentioned earlier in this article, Hamdan et al. (28) were the first to largely report that even the presence of endometriomas did not alter ART results.”

    From Endometrial receptivity in adenomyosis and/or endometriosis (2023) · cites this paper as [28]

  • ART data accumulated in recent years do not confirm that endometrial receptivity is altered in adenomyosis or endometriosis.

    “Indeed, as discussed further in this article, ART data accumulated in the last years fail to confirm that endometrial receptivity is altered in adenomyosis (27) and endometriosis (28).”

    From Endometrial receptivity in adenomyosis and/or endometriosis (2023) · cites this paper as [28]

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Authors
Hamdan, M., Dunselman, G., Li, T. C., & Cheong, Y.
Affiliations
  • Princess Anne Hospital (GB)
  • Maastricht University Medical Centre (NL)
  • Chinese University of Hong Kong (HK)
Corresponding author
Cheong, Y.
ORCID
Venue
Human Reproduction Update
Publisher
Oxford University Press (OUP)
Published
2015-07-12
Volume
21
Issue
6
Pages
809-825
ISSN
  • 1355-4786 (ISSN-L)
  • 1460-2369
DOI
10.1093/humupd/dmv035
OpenAlex
W1904045413
Cited by
375
References
5
Citations by year
2026: 29 · 2025: 41 · 2024: 40 · 2023: 32 · 2022: 42 · 2021: 39 · 2020: 51 · 2019: 23 · 2018: 31 · 2017: 36 · 2016: 10
FWCI
3.89
Type
journal article
Language
en
Open access
Locations
  • Human Reproduction Update (publishedVersion)
  • PubMed (publishedVersion)
  • Research Publications (Maastricht University) (publishedVersion, other-oa)
  • ePrints Soton (University of Southampton) (submittedVersion)
  • HighWire Press Open Archive (submittedVersion)
  • Research Publications (Maastricht University) (submittedVersion, other-oa)
Funders
Ministry of Education Malaysia and Complete Fertility Centre, Southampton
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
  • Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Biology and Fertility
Keywords
endometrioma, endometriosis, in vitro fertilization, intracytoplasmic sperm injection, live birth rate, clinical pregnancy rate, oocyte retrieval, endometrioma surgery, surgical technique, subfertility, antral follicle count, cycle cancellation, ovulation induction, fertility preservation, ovarian reserve, miscarriage, implantation rate, fertilization rate
MeSH terms
Birth Rate, Endometriosis, Female, Fertilization in Vitro, Humans, Infertility, Female, Pregnancy, Pregnancy Outcome, Treatment Outcome, Pregnancy Rate, Sperm Injections, Intracytoplasmic, Oocyte Retrieval, Ovarian Reserve

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