The presence of ovarian endometriomas is associated with a reduced responsiveness to gonadotropins

Objective: To clarify whether the presence of ovarian endometriomas is associated with a reduced responsiveness to ovarian hyperstimulation. Design: Observational study. Setting: University teaching hospital. Patient(s): Women selected for in vitro fertilization-intracytoplasmic sperm injection (IVF-ICSI) cycles: who were found to have unilateral, ovarian endometriomas and who did not undergo previous ovarian surgery. Intervention(s): Ovarian hyperstimulation using gonadotropins. Main Outcome Measure(S): Number of codominant follicle's (mean diameter > 15 mm), in the affected and in the contralateral intact gonads. Result(s): Thirty-six patients were enrolled. They underwent 56 IVF-ICSI cycles. The number of codominant follicles in the intact and affected ovaries were 4.0 +/- 2.2 and 3.0 +/- 1.7, respectively (P=.01). This difference corresponded to a mean reduction (95% confidence interval [CL]),of 25% (6%-44%). This deleterious effect was more evident in women with larger cysts, in those with more than-one cyst, and in those who were more responsive to ovarian-hyperstimulation. Conclusion(s): The presence of ovarian endometriomas is associated with a reduced responsiveness to gonadotropins.