Objective: To compare follicular response to controlled ovarian hyperstimulation (COH) between normal ovaries and ovaries previously treated by different laparoscopic techniques for ovarian endometrioma. Design: A prospective randomized clinical trial. Settings: University and private infertility clinic. Patients: 81 infertile patients with either unilateral or bilateral endometrioma. Interventions: For 65 patients with unilateral endometrioma, laparoscopic ovarian fenestration and coagulation was performed in 24 cases (group 1) and laparoscopic ovarian cystectomy in 41 others (group 2). In 16 patients who had bilateral endometrioma (group 3) cystectomy was done in one ovary and fenestration and coagulation in the contra-lateral side. All patients underwent COH with clomiphene-citrate and HMG in subsequent cycles. Main Outcome Measures: Number of follicles in each ovary of above patients after COH.
Results: Mean number of follicles in group 1 was 2.6 ±1.6 in post fenestration and coagulation ovaries and 2.8±1.6 in normal ovaries. These figures were 3.2±1.1 in postcystectomy ovaries and 3.2±1.7 in normal ovaries in group 2.In group 3 number of follicle was 2.9±1.1 in post-cystectomy ovaries and 3.05±1.3 after fenestration and coagulation. There was no statistical significant difference between these figures.
Conclusions: Response of ovaries to COH after laparoscopic ovarian cystectomy or fenestration and coagulation was the same. There was no difference in response to COH between normal ovaries and those operated by laparoscopic techniques mentioned above.