Massimo Candiani, Stefano M Ferrari, Noemi Salmeri, Carolina Dolci, Roberta Villanacci, Ludovica Bartiromo, Matteo Schimberni, Iacopo Tandoi, Jessica Ottolina
{"title":"CO2纤维激光汽化治疗子宫内膜异位瘤对接受抗逆转录病毒治疗的不孕症妇女的卵巢反应性和胚胎质量均有改善。","authors":"Massimo Candiani, Stefano M Ferrari, Noemi Salmeri, Carolina Dolci, Roberta Villanacci, Ludovica Bartiromo, Matteo Schimberni, Iacopo Tandoi, Jessica Ottolina","doi":"10.23736/S2724-606X.22.05188-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Infertile women carrying ovarian endometriomas can be managed either with surgery or by in-vitro fertilization (IVF). The aim of this study was to compare ovarian responsiveness to controlled ovarian stimulation (COS) in assisted reproduction techniques (ART) in infertile women carrying small intact endometriomas and those managed by endometrioma cystectomy or CO<inf>2</inf> fiber laser ablation.</p><p><strong>Methods: </strong>Retrospective case-control study of prospectively collected data including women underwent ART for endometriosis-related infertility. The study group consisted of infertile women undergoing endometriomas CO<inf>2</inf> fiber laser vaporization before ART (\"ART after laser CO<inf>2</inf>\" group). Controls were infertile women with endometrioma managed by cystectomy before ART (\"ART after cystectomy\" group) and infertile women with small endometriomas undergoing ART as first approach (\"ART only\" group).</p><p><strong>Results: </strong>Of the 86 included patients, 27 (31.4%) belonged to \"ART after laser CO<inf>2</inf>\" group, 37 (43%) to \"ART after cystectomy\" group and 22 (25.6%) to \"ART only\" group. Surgical groups had larger endometriomas than patients referred to \"ART only\" group. No between-groups differences were observed in terms of COS protocol, gonadotropins starting and total doses and length of COS. While women belonged to \"ART after cystectomy\" group had fewer recruited follicles (P=0.014), oocytes (P=0.042), MII oocytes (P=0.042) and formed embryos (P=0.004) compared to women of \"ART only\" group, no significant differences were found between patients of \"ART only\" group \"ART after laser CO<inf>2</inf>\" group. A greater number of good-quality embryos were observed in surgical groups. No between-groups differences were found in clinical pregnancy rates.</p><p><strong>Conclusions: </strong>Our results demonstrate encouraging findings on IVF/ICSI outcomes after laser CO<inf>2</inf> endometrioma ablation in terms of both quantity and quality of developed embryos.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":"75 4","pages":"348-356"},"PeriodicalIF":1.6000,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"2","resultStr":"{\"title\":\"CO2 fiber laser vaporization for endometrioma treatment results in preserved ovarian responsiveness and improved embryo quality in infertile women undergoing ART.\",\"authors\":\"Massimo Candiani, Stefano M Ferrari, Noemi Salmeri, Carolina Dolci, Roberta Villanacci, Ludovica Bartiromo, Matteo Schimberni, Iacopo Tandoi, Jessica Ottolina\",\"doi\":\"10.23736/S2724-606X.22.05188-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Infertile women carrying ovarian endometriomas can be managed either with surgery or by in-vitro fertilization (IVF). The aim of this study was to compare ovarian responsiveness to controlled ovarian stimulation (COS) in assisted reproduction techniques (ART) in infertile women carrying small intact endometriomas and those managed by endometrioma cystectomy or CO<inf>2</inf> fiber laser ablation.</p><p><strong>Methods: </strong>Retrospective case-control study of prospectively collected data including women underwent ART for endometriosis-related infertility. The study group consisted of infertile women undergoing endometriomas CO<inf>2</inf> fiber laser vaporization before ART (\\\"ART after laser CO<inf>2</inf>\\\" group). Controls were infertile women with endometrioma managed by cystectomy before ART (\\\"ART after cystectomy\\\" group) and infertile women with small endometriomas undergoing ART as first approach (\\\"ART only\\\" group).</p><p><strong>Results: </strong>Of the 86 included patients, 27 (31.4%) belonged to \\\"ART after laser CO<inf>2</inf>\\\" group, 37 (43%) to \\\"ART after cystectomy\\\" group and 22 (25.6%) to \\\"ART only\\\" group. Surgical groups had larger endometriomas than patients referred to \\\"ART only\\\" group. No between-groups differences were observed in terms of COS protocol, gonadotropins starting and total doses and length of COS. While women belonged to \\\"ART after cystectomy\\\" group had fewer recruited follicles (P=0.014), oocytes (P=0.042), MII oocytes (P=0.042) and formed embryos (P=0.004) compared to women of \\\"ART only\\\" group, no significant differences were found between patients of \\\"ART only\\\" group \\\"ART after laser CO<inf>2</inf>\\\" group. A greater number of good-quality embryos were observed in surgical groups. No between-groups differences were found in clinical pregnancy rates.</p><p><strong>Conclusions: </strong>Our results demonstrate encouraging findings on IVF/ICSI outcomes after laser CO<inf>2</inf> endometrioma ablation in terms of both quantity and quality of developed embryos.</p>\",\"PeriodicalId\":18572,\"journal\":{\"name\":\"Minerva obstetrics and gynecology\",\"volume\":\"75 4\",\"pages\":\"348-356\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2023-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"2\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Minerva obstetrics and gynecology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.23736/S2724-606X.22.05188-0\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Minerva obstetrics and gynecology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.23736/S2724-606X.22.05188-0","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
CO2 fiber laser vaporization for endometrioma treatment results in preserved ovarian responsiveness and improved embryo quality in infertile women undergoing ART.
Background: Infertile women carrying ovarian endometriomas can be managed either with surgery or by in-vitro fertilization (IVF). The aim of this study was to compare ovarian responsiveness to controlled ovarian stimulation (COS) in assisted reproduction techniques (ART) in infertile women carrying small intact endometriomas and those managed by endometrioma cystectomy or CO2 fiber laser ablation.
Methods: Retrospective case-control study of prospectively collected data including women underwent ART for endometriosis-related infertility. The study group consisted of infertile women undergoing endometriomas CO2 fiber laser vaporization before ART ("ART after laser CO2" group). Controls were infertile women with endometrioma managed by cystectomy before ART ("ART after cystectomy" group) and infertile women with small endometriomas undergoing ART as first approach ("ART only" group).
Results: Of the 86 included patients, 27 (31.4%) belonged to "ART after laser CO2" group, 37 (43%) to "ART after cystectomy" group and 22 (25.6%) to "ART only" group. Surgical groups had larger endometriomas than patients referred to "ART only" group. No between-groups differences were observed in terms of COS protocol, gonadotropins starting and total doses and length of COS. While women belonged to "ART after cystectomy" group had fewer recruited follicles (P=0.014), oocytes (P=0.042), MII oocytes (P=0.042) and formed embryos (P=0.004) compared to women of "ART only" group, no significant differences were found between patients of "ART only" group "ART after laser CO2" group. A greater number of good-quality embryos were observed in surgical groups. No between-groups differences were found in clinical pregnancy rates.
Conclusions: Our results demonstrate encouraging findings on IVF/ICSI outcomes after laser CO2 endometrioma ablation in terms of both quantity and quality of developed embryos.
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