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Updated: Jun 17, 2026
Surgical Techniques to Optimize Ovarian Reserve during Laparoscopic Cystectomy for Ovarian Endometrioma
Published on: January 22, 2022
Rate of severe ovarian damage following surgery for endometriomas
Laura Benaglia1, Edgardo Somigliana, Valentina Vighi
1Infertility Unit, Fondazione Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Via M Fanti 6, 20122 Milan, Italy. laurabenaglia@hotmail.it
Background:
There is growing and consistent evidence showing that ovarian reserve is affected following surgical excision of ovarian endometriomas. Of particular concern is the risk of severe ovarian damage leading to unresponsiveness to ovarian hyperstimulation. In this study, we aimed to determine the rate of this complication.
Methods:
Ninety-three women underwent surgery for monolateral endometriomas were recruited. Patients who underwent IVF were selected and, in all cases, follicular growth was monitored by serial transvaginal ultrasonography. The main outcome measure was the rate of ovaries remaining silent when stimulated after surgery for endometriomas.
Results:
Absence of follicular growth was observed in 12 operated ovaries although this event never occurred in the contralateral gonad (P < 0.001). The frequency (95% confidence interval) of severe ovarian damage following surgery was 13% (7-21%).
Conclusions:
Severe ovarian damage, occurring in gonads operated on for ovarian endometriomas, is not a rare event.
