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Wu CQ, Albert A, Alfaraj S, Taskin O, Alkusayer GM, Havelock J, Yong P, Allaire C, Bedaiwy MA. Live Birth Rate after Surgical and Expectant Management of Endometriomas after In Vitro Fertilization: A Systematic Review, Meta-Analysis, and Critical Appraisal of Current Guidelines and Previous Meta-Analyses. J Minim Invasive Gynecol 2018; 26:299-311.e3. [PMID: 30717864 DOI: 10.1016/j.jmig.2018.08.029] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 07/30/2018] [Accepted: 08/13/2018] [Indexed: 12/26/2022]
Abstract
Controversy exists regarding surgical management of endometriomas in infertile women before in vitro fertilization (IVF) because growing evidence indicates that surgery may impair the ovarian response. The objective of the present systematic review and meta-analysis was to compare surgical and expectant management of endometriomas regarding IVF outcomes. Prospective and retrospective controlled studies were found via the Cochrane Library, Embase, and MEDLINE databases. Thirteen studies (1 randomized controlled trial and 12 observational studies, N = 2878) were pooled, and similar live birth rates were observed in the surgically and expectantly managed groups (odds ratio = 0.83; 95% confidence interval [CI], 0.56-1.22; p = .98). The clinical pregnancy rates (odds ratio = 0.83; 95% CI, 0.66-1.05; p = .86), the number of mature oocytes retrieved, and the miscarriage rates were not statistically different between study groups. However, the total number of oocytes retrieved was lower in the surgery group (mean difference = -1.51; 95% CI, -2.60 to -0.43; p = .02). Findings suggest that surgical management of endometriomas before IVF therapy yields similar live birth rates as expectant management. However, future properly designed randomized controlled trials are warranted.
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Affiliation(s)
- Clara Q Wu
- Department of Obstetrics and Gynecology, University of Saskatchewan, Regina, Saskatchewan, Canada (Dr. Wu)
| | - Arianne Albert
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada (Drs. Albert, Alfaraj, Taskin, Havelock, Yong, Allaire, and Bedaiwy)
| | - Sukainah Alfaraj
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada (Drs. Albert, Alfaraj, Taskin, Havelock, Yong, Allaire, and Bedaiwy)
| | - Omur Taskin
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada (Drs. Albert, Alfaraj, Taskin, Havelock, Yong, Allaire, and Bedaiwy)
| | - Ghadeer M Alkusayer
- Department of Obstetrics and Gynecology, University of Manitoba, Winnipeg, Manitoba, Canada (Dr Alkusayer); Department of Clinical Sciences, College of Medicine, Princess Nourah Bint Abdulrahman University, Kingdom of Saudi Arabia (Dr Alkusayer)
| | - Jon Havelock
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada (Drs. Albert, Alfaraj, Taskin, Havelock, Yong, Allaire, and Bedaiwy)
| | - Paul Yong
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada (Drs. Albert, Alfaraj, Taskin, Havelock, Yong, Allaire, and Bedaiwy)
| | - Catherine Allaire
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada (Drs. Albert, Alfaraj, Taskin, Havelock, Yong, Allaire, and Bedaiwy)
| | - Mohamed A Bedaiwy
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada (Drs. Albert, Alfaraj, Taskin, Havelock, Yong, Allaire, and Bedaiwy).
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Peng B, Zhan H, Alotaibi F, Alkusayer GM, Bedaiwy MA, Yong PJ. Nerve Growth Factor Is Associated With Sexual Pain in Women With Endometriosis. Reprod Sci 2017; 25:540-549. [DOI: 10.1177/1933719117716778] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Bo Peng
- Department of Obstetrics & Gynaecology, The University of British Columbia, Vancouver, British Columbia, Canada
- Child & Family Research Institute, Vancouver, British Columbia, Canada
| | - Hong Zhan
- Department of Obstetrics & Gynaecology, The University of British Columbia, Vancouver, British Columbia, Canada
- Child & Family Research Institute, Vancouver, British Columbia, Canada
| | - Fahad Alotaibi
- Department of Obstetrics & Gynaecology, The University of British Columbia, Vancouver, British Columbia, Canada
- Child & Family Research Institute, Vancouver, British Columbia, Canada
| | - Ghadeer M. Alkusayer
- Department of Clinical Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia
| | - Mohamed A. Bedaiwy
- Department of Obstetrics & Gynaecology, The University of British Columbia, Vancouver, British Columbia, Canada
- Child & Family Research Institute, Vancouver, British Columbia, Canada
- BC Women’s Centre for Pelvic Pain and Endometriosis, Vancouver, British Columbia, Canada
| | - Paul J. Yong
- Department of Obstetrics & Gynaecology, The University of British Columbia, Vancouver, British Columbia, Canada
- Child & Family Research Institute, Vancouver, British Columbia, Canada
- BC Women’s Centre for Pelvic Pain and Endometriosis, Vancouver, British Columbia, Canada
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