Objective: To clarify whether the presence of ovarian endometriomas is associated with a reduced responsiveness to ovarian hyperstimulation.
Design: Observational study.
Setting: University teaching hospital.
Patient(s): Women selected for in vitro fertilization-intracytoplasmic sperm injection (IVF-ICSI) cycles who were found to have unilateral ovarian endometriomas and who did not undergo previous ovarian surgery.
Intervention(s): Ovarian hyperstimulation using gonadotropins.
Main outcome measure(s): Number of codominant follicles (mean diameter >15 mm) in the affected and in the contralateral intact gonads.
Result(s): Thirty-six patients were enrolled. They underwent 56 IVF-ICSI cycles. The number of codominant follicles in the intact and affected ovaries were 4.0 +/- 2.2 and 3.0 +/- 1.7, respectively (P=.01). This difference corresponded to a mean reduction (95% confidence interval [CI]) of 25% (6%-44%). This deleterious effect was more evident in women with larger cysts, in those with more than one cyst, and in those who were more responsive to ovarian hyperstimulation.
Conclusion(s): The presence of ovarian endometriomas is associated with a reduced responsiveness to gonadotropins.