Objective: To determine which of the following factors at initial surgery-such as diameter of largest endometriotic cyst, number of cysts, diseases severity, type of surgery (laparoscopy versus laparotomy), or postoperative medical therapy-best correlated with the time of recurrence of ovarian endometrioma. Design: A retrospective descriptive study was performed on 25 patients who underwent initial surgical excision of endometriotic cyst and had cyst recurrence demonstrated either on ultrasound or repeat surgery. The clinical presentation of cyst recurrence was described. The operative findings of the first and second surgeries were compared. Factors which may affect the time of cyst recurrence were evaluated. Results: Cyst recurrence was demonstrated by ultrasound in 24 (96 percent) cases; repeat surgery for recurrence was done in only 10 (40 percent) cases. The different factors in the initial surgery: type of operation, size, number, and laterality of the endometriotic cyst, disease severity, adhesions and postoperative medical therapy, did not influence the time of recurrence of ovarian endometrioma. Disease severity was a significant factor on repeat surgery. Conclusion: The different factors aforementioned, which were present in the first surgery, did not influence the time of recurrence of ovarian endometrioma.
Human ; Female ; Adult ; ENDOMETRIOSIS ; RECURRENCE

Background: Growth hormone has been used as an adjunct in ovarian stimulation of IVF cycles for the past three decades. However, the exact mechanism of its role in improving oocyte quality has not been thoroughly investigated. Although a clear indication for GH co-treatment is in infertile women with GH deficiency, GH has been given mostly to poor ovarian responders. Method: This paper is a review of the most recent published data on the role of GH supplementation in improving oocyte quality in younger women who are suboptimal or unexpected poor responders to standard ovarian stimulation. Results: Retrospective cohort and randomized trials demonstrated an improvement in oocyte quality through morphological parameters, mitochondrial function, biomarkers, GH receptors, insulin growth factor, markers of oxidative stress, mature oocytes, good quality embryos, implantation rate, clinical pregnancy and live birth. Conclusion Current data suggest GH supplementation may improve oocyte and embryo qualities, endometrial receptivity, clinical pregnancy and live birth. However, better quality evidence is needed before a recommendation can be made for GH supplementation to be given to infertile women who are suboptimal or poor ovarian responders.
growth hormone ; hormone receptor ; IGF-1 ; IVF