Indexed and abstracted in Science Citation Index Expanded and in Journal Citation Reports /Science Edition Bratisl Lek Listy 2012; 113 (9) 544 – 547 DOI: 10.4149/BLL_2012_122 CLINICAL STUDY Does ovarian endometrioma affect the number of oocytes retrieved for in vitro fertilization? Kiran H 1 , Arikan DC 1 , Kaplanoglu M 2 , Bisak U 3 , Cetin MT 3 Kahramanmaras Sutcuimam University, Medical Faculty, Department of Obstetrics and Gynecology, Kahramanmaras, Turkey. drdenizarikan@hotmail.com Abstract: Objective: To investigate the effects of ovarian endometrioma on the number of oocytes retrieved for in vitro fertilization (IVF). Background: The presence of endometrioma may be the most important predictor of a poor reproductive out- come. Literature data suggest that ovarian endometriomas might affect the response to ovarian stimulation and oocyte retrieval. Methods: The present retrospective study evaluates 2,023 women who applied to our center with an infertility complaint. Twenty-nine women with endometriomas (group 1) who were treated with IVF were included in the study. They were compared with 51 women with unexplained infertility (group 2) regarding the number of re- trieved oocytes after egg retrieval and number of metaphase II oocytes. The diagnosis of endometrioma was made via ultrasound examination with the identification of low-density cystic masses in the ovaries. The patients underwent a controlled ovarian hyperstimulation (COH) with either the long agonist mini-dose protocol or the multi-dose antagonist protocol. Results: The incidence of endometrioma in infertile women was found to be 1.4 %. The women’s ages ranged between 24 and 45 years, and the duration of their infertility ranged between 12 and 216 months. The endo- metrioma was bilateral in 24 % of the cases. The mean endometrioma diameter was 26.2±7.3 mm for the right ovary and 23.2±6.1 mm for the left ovary. The average number of retrieved oocytes after egg retrieval in groups 1 and 2 was 12.4 ± 8.3 and 12.2 ± 8.6, respectively. The average number of metaphase II oocytes in groups 1 and 2 was 8.6±6.1 and 9.4±7.3, respectively. The number of retrieved oocytes after egg retrieval and the number of metaphase II oocytes in both endometrioma group and unexplained infertile group were similar (p > 0.05). Conclusion: Endometrioma did not reduce the number of retrieved oocytes in a COH cycle for IVF treatment. However it should be noted that the ovarian response is affected by the size of endometriomas, bilaterality, pre- vious surgeries, recurrence, and the patient’s age (Tab. 1, Ref. 31). Full Text in PDF www.elis.sk. Key words: endometrioma, oocyte, infertility. 1 Kahramanmaras Sutcuimam University, Medical Faculty, Department of Obstetrics and Gynecology, Kahramanmaras, Turkey, 2 Gozde Surgical Medical Center, Department of Obstetrics and Gynecology, Mersin, Tur- key, and 3 Prof Dr M Turan Cetin IVF Center, Department of Obstetrics and Gynecology, Adana, Turkey Address for correspondence: D.C. Arikan, Kahramanmaras Sütcüimam Üniversitesi, Kadin Hastaliklari ve Dogum Anabilimdali, Yörük Selim Mah. Gazi Mustafa Kuscu Cad. 46050 Kahramanmaras, Turkey. Phone: +90.505.8022847, Fax: +90.344.2212371 Ovarian endometriomas arise as a result of the development of endometriotic tissues in the ovary. Their inside is generally filled with dense aqua containing hemosiderin, which gives them the color of chocolate. Recently the diagnosis of ovarian endometriomas can be made by transvaginal ultrasonography. The view of widespread low-density echoes within the echogenic cyst wall in the ovary is a typical sonographic feature for the diagnosis of endometrioma (1). The sensitivity of ultrasonography was defined as 80 % in endo- metrioma diagnosis whereas the specifity was more than 95 % (2). Endometriomas usually contain thick tar-like fluid; such cysts often densely adhere to the peritoneum of the ovarian fossa and the surrounding fibrosis may involve the tubes and bowel (3). It is a common pathology among women with endometriosis, and af- fects 1 7– 44 % of patients with endometriosis (4). It is generally unilateral (72 – 81 %) (5). Dede et al evaluated the management of incidental adnexal masses observed at the time of cesarean section. The masses were diagnosed as endometrioma in 4.4 % of cases (6). Classically, alterations in the production of interleukins, other cytokines, and growth factors are known to occur in the presence of endometriosis in addition to an increase in the number of apoptotic bodies in granulosa cells, changes in the inflammatory response and autoimmune factors and interference with steroid levels, possibly having a negative impact on follicular growth, oocyte quality and implantation rates during assisted reproduction cycles (7 – 9). The presence of endometrioma may be the most important predictor of a poor reproductive outcome (10 – 12). Previous reports have sug- gested that ovarian endometriomas might produce substances that are toxic to oocytes (13) and impair the oocyte development (14). Literature data have suggested that ovarian endometriomas might affect the response to ovarian stimulation and oocyte re- trieval (14 – 16). In this study, we investigated the number of oocytes retrieved from women who had ovarian endometriomas through in vitro fertilization (IVF) cycles.