The Effect Of Cystectomy For Ovarian Endometriomas On Ovarian Reserve And The Outcome Of ART:a Meta Analysis

Objective:To conduct a systematic review and meta-analysis of the effect of cystectomy for ovarian endometriomas on ovarian reserve and outcome of ARTMaterials and method:We searched the databases from PubMed and MEDLINE. Languages was restricted to English, and no time limit. The study group consisted of women with endometrioma undergoing IVF after surgical treatment. The control groups consisted of women with endometrioma undergoing IVF without surgical treatment. Evaluation the the retrieved articles, exclude the articles that mismatch the research purpose and quality requirements. Meta-analysis was conducted using Review Manager5.0software. Data including basal follicle stimulate hormone, Estradiol peak, number of oocytes retrieved, fertilization rate, implantation rate, pregnaney rate, clinical pregnancy rate, and live birth rate.Using the index of odds ratio to express the result for the categorical variable and weighted mean difference to to express the result for the continuous variable respectively.Results:There are eight trials including965patients were included, including one randomized clinical trials and seven controlled clinical trials. None of the CCT described randomization or usage of double blinded. Results showed that the cystectomy for ovarian endometriomas don’t decrease the level of basal follicle stimulate hormone[WMD=0.1,95%CI:(-0.36,-0.04), p=0.5], Estradiol peak[WMD=-190.50,.95%CI:(-547.23,166.24), p=0.30], number of oocytes retrieved[WMD=-1.53,95%CI (-3.23,0.17), P=0.08], and don’t reduce the fertilization rate[OR=8.45,95%CI (2.97,24.06), p=0.17], implantation rate[OR=1.09,95%CI (0.76,1.56), p=0.64], pregnaney rate[OR=1.09,95%CI (0.56,2.12), P=0.80], clinical pregnancy rate[OR=1.30,95%CI (0.87,1.95), p=0.21], and live birth rate[OR=1.92,95%CI (0.75,4.9), p=0.41]. Similarly, there was no statistical significant difference between the two groups with regard to the ovarian reserve and outcome of ARTConclusion:Collectively the available data in the literature show that surgical management of endometriomas has no significant effect on the ovarian reserve and outcome of ART. But most of the articles included are CCT, and there are the possibility of selective bias, publication bias and measurement bias, so more RCT are needed to corroborate these preliminary results.