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Effects of ovarian endometrioma aspiration on in vitro fertilization-intracytoplasmic sperm injection and embryo transfer outcomes: a systematic review and meta-analysis

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Abstract

Purpose

To evaluate the effect of ovarian endometrioma aspiration on IVF/ICSI outcomes.

Methods

The PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure, and Wanfang databases were searched to identify studies related to the treatment of endometrioma up to October 1, 2020, and the data of 1207 patients from 10 studies were analyzed using STATA.

Results

The 10 studies in our analysis included 7 comparing aspiration and surgery and 6 comparing aspiration with no intervention. In the aspiration versus surgery groups, live birth rate [OR 0.97 (95% CI 0.51, 1.85), P = 0.925] and clinical pregnancy rate [OR 1.30 (95% CI 0.95, 1.80), P = 0.105] showed no significant difference between the two groups. Abortion rate [OR 4.26 (95% CI 1.38, 13.08), P = 0.011], the number of oocytes retrieved [mean difference 1.95 (95% CI 0.10, 3.81), P = 0.039], and the estradiol peak on hCG day [mean difference 392.16 (95% CI 230.14, 554.18), P < 0.001] were significantly higher in the aspiration group compared to the surgical group. In the aspiration versus the no intervention group, live birth rate [OR 0.84 (95% CI 0.45, 1.59), P = 0.602] and clinical pregnancy rate [OR 1.25 (95% CI 0.88, 1.77), P = 0.206] were not significantly different between the two groups. The abortion rate [OR 0.31 (95% CI 0.11, 0.88), P = 0.028] and the number of gonadotropin ampoules [mean difference − 3.13 ampoules (95% CI − 4.90, − 1.37), P < 0.001] were significantly lower in the aspiration group compared to the no intervention group.

Conclusion

Compared with surgical treatment or no intervention treatment, aspiration has less effect on ovarian response, ovarian reserve, and pregnancy outcomes.

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Acknowledgements

The authors thank all the participants of this study. In addition, we would like to thank Editage (www.editage.cn) for English language editing.

Funding

This study was supported by the National Natural Science Foundation of China (82071617).

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Authors and Affiliations

  1. Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan, 2500012, Shandong, China

    Xinyan Gao, Yousheng Zhang, Xinxin Xu, Shaoming Lu & Lei Yan

  2. National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China

    Xinyan Gao, Yousheng Zhang, Xinxin Xu, Shaoming Lu & Lei Yan

  3. Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China

    Xinyan Gao, Yousheng Zhang, Xinxin Xu, Shaoming Lu & Lei Yan

  4. Shandong Provincial Clinical Medicine Research Center for Reproductive Health, Shandong University, Jinan, 250012, Shandong, China

    Xinyan Gao, Yousheng Zhang, Xinxin Xu, Shaoming Lu & Lei Yan

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  1. Xinyan Gao
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  2. Yousheng Zhang
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Contributions

XYG: Data collection, data analysis, manuscript writing/editing. YSZ: Data collection, data analysis, manuscript writing/editing. XXX: Data collection, data analysis, manuscript writing/editing. LY: Protocol development, manuscript writing/editing. SML: Protocol development, manuscript writing/editing. All authors reviewed and approved the final manuscript.

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Correspondence to Lei Yan.

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Gao, X., Zhang, Y., Xu, X. et al. Effects of ovarian endometrioma aspiration on in vitro fertilization-intracytoplasmic sperm injection and embryo transfer outcomes: a systematic review and meta-analysis. Arch Gynecol Obstet 306, 17–28 (2022). https://doi.org/10.1007/s00404-021-06278-2

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