Ovarian Endometrioma Does Not Affect Egg Quality, Study Suggests

Oocyte yield may decrease but oocyte quality does not seem to be affected in women with ovarian endometriomas.

Key Points

Highlights: 

• Ovarian endometrioma does have a negative impact on oocyte yield but not on oocyte quality.

Importance:

• Patients with ovarian endometrioma could confidently pursue IVF before surgery.

What’s done here:

• Researchers conducted a systematic review and meta-analysis of the literature.

Key results:

• There was no significant difference in the rates of fertilization, blastulation, and cancellation between patients with ovarian endometriomas and patients without ovarian abnormalities.
• Women with ovarian endometriomas had significantly lower numbers of total and mature oocytes and lower numbers of top-quality embryos compared to women without ovarian abnormalities.
• The Ovarian Sensitivity Index between women with ovarian endometriomas and women without ovarian abnormalities was similar.

Limitations:

• Oocyte quality was assessed through indirect markers. 
• Most studies did not specify the number of IVF or ICSI cycles conducted in each group.
• Some studies analyzed had a small sample size and most were retrospective studies, which could reduce the reliability of the analysis. 

Lay Summary

Ovarian endometrioma could decrease oocyte yield in patients undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI), according to a new literature review and meta-analysis published in the scientific journal Reproductive BioMedicine Online. However, it does not seem to have an adverse effect on oocyte quality.

“These groundbreaking findings hold significant implications for counseling patients with [ovarian endometriomas]”, said the authors of the study. “The evidence presented suggests that individuals with [ovarian endometriomas] can confidently pursue IVF before surgery, obtaining oocytes with comparable potential to women without [ovarian endometriomas], based on the best available evidence”.

To evaluate the effect of ovarian endometriomas on indirect markers of oocyte quality in patients undergoing IVF, a team of researchers led by Dr. José Moreno-Sepulveda from Clínica de la Mujer Medicina Reproductiva, Viña del Mar, in Chile conducted a systematic review and meta-analysis of the literature. 

The literature search included original randomized controlled clinical trials, case-control studies, and cohort studies published until October 2023. 

A total of 31 studies were identified and included in the meta-analysis.  The results showed no significant difference in fertilization, blastulation, and cancellation rates between patients with ovarian endometriomas and those without ovarian abnormalities. However, patients with ovarian endometriomas had significantly lower numbers of total and mature oocytes and lower numbers of top-quality embryos compared to women without ovarian abnormalities. 

The Ovarian Sensitivity Index between the 2 groups of women was similar. The researchers said that they could not conduct a meta-analysis on the rate of euploidy due to the lack of published data.

They concluded that ovarian endometrioma does not affect oocyte quality contrary to assumptions.

Research Source: https://pubmed.ncbi.nlm.nih.gov/38943812/