Surgery for ovarian cysts may hurt fertility

This article will be of interest to women with ovarian cysts due to endometriosis or other causes and who are considering treatment with in vitro fertilization – IVF.

A recent study presented at the annual meeting of the American Association of Gynecologic Laparoscopists, compared IVF patients who first underwent surgery to remove ovarian cysts to those who left the cysts intact.

Previous studies suggested that surgery might damage the ovaries and thus compromise a woman’s ovarian reserve.

The study examined 205 women who underwent in vitro fertilization at a program in China. The investigators reviewed data from 127 women who had laparoscopic ovarian cyst removal for endometriosis cysts and 78 women who did not have cyst removal. The women were aged 38 years and younger, with an average age of 33 years, and the mean duration of infertility was 5 years for both groups.

Compared to the group who did not have surgery, the cyst removal group had almost 30% fewer eggs retrieved during their IVF cycles. This is despite the fact the surgery group had more days of stimulation and used higher doses of fertility medications. Even within the same patient, there were fewer developed follicles and fewer eggs retrieved when comparing the ovary that had surgery to the ovary that did not.

Ultimately, the surgery group had fewer high-quality embryos available for transfer, compared with the controls.

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