Surgical treatment for endometrioma does not increase clinical pregnancy rate or live birth/ongoing pregnancy rate after fresh IVF/ICSI treatment

The impact of surgical treatment for endometrioma prior to assisted reproductive treatment (ART) on pregnancy outcomes remains controversy. The aim of this study is to investigate whether surgery provides benefits in subsequent ART outcomes. We retrospectively analyzed the data of 292 patients who underwent their first attempted IVF/ICSI treatment at fertility center in a university hospital, from 2011 to 2013. The primary outcomes included clinical pregnancy rate (CPR), live birth/ongoing pregnancy rate (LB/OPR). Although patients with no history of surgery and with visual endometriomas during IVF/ICSI treatment had fewer antral follicles (9.3±4.9 vs. 11.0±5.3, P=0.046), and required higher dosage of gonadotropin (3122.8±1118.1 vs. 2741.7±1096.0, P=0.043) when compared to patients who underwent surgery for endometriomas and without visual endometriomas during IVF/ICSI, the CPR and LB/OPR was not significantly affected (OR=0.771, 95%CI=0.398-1.495, and OR=1.043, 95%CI=0.526-2.069, respectively). In conclusion, surgical treatment does not significantly improve pregnancy outcomes in patients who plan to take IVF/ICSI treatment.