National survey of the current management of endometriomas in women undergoing assisted reproductive treatment
Human Reproduction, 06/14/2012
Raffi F et al. – Despite the available evidence that surgery for endometriomas does not improve the outcome of ART and may damage ovarian reserve, it seems that the majority of gynaecologists in the UK offer ovarian cystectomy to their patients.Methods
- All clinicians fully registered with the Royal College of Obstetricians and Gynaecologists were contacted.
- An 11–item survey was administered electronically using Survey Monkey software.
- Quantitative data were analysed using descriptive and comparative statistics.
- The majority of responders were consultants (65%), 25% practiced ART and 65% performed laparoscopic surgery.
- Overall, 95% of responders would offer surgery for endometriomas in women undergoing ART, either on the basis of the size (>3–5 cm) of the endometrioma (52%), the presence of symptoms (16%), the presence of multiple/bilateral endometriomas (2%), regardless of the size and symptoms (19%) or only to women undergoing IVF (6%).
- The remaining 5% of responders would not offer surgery before ART.
- Excision was the most common surgical modality (68%), followed by ablation (25%).
- Laparoscopic surgeons were almost twice as likely to ‘offer surgery to all patients with endometriomas prior to ART’ compared with clinicians performing laparotomy (22 versus 12%, P < 0.001).