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Hum. Reprod. Advance Access published online on June 5, 2009
Human Reproduction, doi:10.1093/humrep/dep202
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© The Author 2009. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Endometriotic ovarian cysts negatively affect the rate of spontaneous ovulation

Laura Benaglia1,2,3, Edgardo Somigliana1, Paolo Vercellini1,2, Annalisa Abbiati1,2, Guido Ragni1 and Luigi Fedele1,2

1 Infertility Unit, Fondazione Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Via M. Fanti 6, 20122 Milan, Italy 2 Università degli Studi di Milano, Milan, Italy

3Correspondence address. Tel: +39-02-55034303; Fax: +39-02-55034302; E-mail: laurabenaglia{at}hotmail.it

BACKGROUND: A growing body of evidence suggests that ovarian reserve is damaged after excision of ovarian endometriomas. However, it may not be excluded that gonadal damage is at least partly caused by the very presence of an endometrioma per se, thus preceding surgery. To clarify this aspect, we set up a prospective study in women with monolateral endometriomas in order to assess the rate of ovulation in affected ovaries.

MATERIALS AND METHODS: Seventy women with monolateral endometriomas who had not undergone previous adnexal surgery underwent serial ecographic examinations to determine the side of ovulation.

RESULTS: Ovulation occurred in the affected ovary in 22 cases (31%; 95% CI: 22–43%). Assuming that the expected rate of ovulation in both ovaries in healthy women is similar, this difference is statistically significant (P = 0.002).

CONCLUSION: The physiological mechanisms leading to ovulation are deranged in ovaries with endometriomas.

Key words: endometriosis/endometrioma/ovulation

Submitted on March 27, 2009; resubmitted on May 1, 2009; accepted on May 6, 2009.


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A. Tocci, C. Lucchini, M. G. Minasi, and E. Greco
Unilateral ovarian endometriotic cysts do not impair follicles development, oocyte and embryo quality: report on eight controlled ovarian hyperstimulations and ICSI cycles
Hum. Reprod., November 21, 2009; (2009) dep402v1.
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L. Benaglia and E. Somigliana
Reply: Report of three infertile patients with unilateral ovarian endometriotic cysts diagnosed by ultrasound
Hum. Reprod., November 17, 2009; (2009) dep403v1.
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