A Study on Clinical Response to Controlled Ovarian Hyperstimulation of In VitroFertilization and Embryo Transfer According to the Size of Baseline Ovarian Cyst.
- Author:
Yong Soek LEE
;
Byeong Jun JUNG
;
Sang Hoon LEE
;
Min HUR
- Publication Type:Original Article ; In Vitro
- MeSH:
Chorionic Gonadotropin;
Embryo Transfer*;
Embryonic Structures*;
Endometriosis;
Estradiol;
Female;
Fertilization in Vitro;
Gonadotropin-Releasing Hormone;
Gonadotropins;
Humans;
Infertility;
Male;
Oocytes;
Ovarian Cysts*;
Ovary;
Pregnancy Rate;
Retrospective Studies;
Ultrasonography
- From:Korean Journal of Fertility and Sterility
1999;26(3):355-362
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: This study was performed to compare the clinical response to controlled ovarian hyperstimulation (COH) of in vitro fertilization and embryo transfer (IVF-ET) according to the size of baseline ovarian cyst. METHOD: From February 1992 to March 1999, a retrospective analysis was done of 272 cases who underwent COH using mid-luteal phase long protocol of gonadotropin-releasing hormone agonist (GnRH-a) for IVF-ET. These cases were divided into four group; group 1 (n=63) had cysts with mean diameters between 20.2 and 29.0 mm on their baseline ultrasound on cycle day 3, group 2 (n=57, 30.0~49.0mm), group 3 (n=68, >50.0mm) and control group (n=84). Cases were excluded according to the following criteria; pure male factor infertility, the presence of only one ovary, high CA-125 level and previous endometriosis. RESULTS: There were no statistically significant differences between cases with baseline ovarian cyst <50.0 mm in diameter and control group in any of the parameters. However, cases with baseline ovarian cyst>50.0 mm in mean diameter needed more amount of human menopausal gonadotropin (hMG), showed significantly lower estradiol (E2) level, the number of follicle >15.0 mm on the day of human chorionic gonadotropin (hCG) administration, the number of oocytes retrieved, the number of mature oocytes, and pregnancy rate compared with control group. CONCLUSION: This study suggests that cases with baseline overian cyst <50.0 mm in diameter do not adversely impact on IVF-ET outcome. However, cases with baseline ovarian cyst >50.0 mm in diameter had adverse effects on various parameters. Therefore, to improve the outcome of IVF-ET in these cases, ovarian cyst aspiration prior to initiating COH may be required.
