Long-term outcomes of treatment of infertile female patients with endometrioid ovarian cysts
The objective. To study long-term outcomes of treatment of infertile patients with endometrioid ovarian cysts depending on a surgical technique of cystectomy. Patients and methods. The study included 120 female patients with infertility and endometrioid cysts of the ovaries. Group 1 comprised 60 patients, who received operative treatment using a novel technique of cystectomy; group 2 - 60 patients, who underwent traditional cystectomy. Hormonal, echographic and Doppler parameters of ovarian reserve were examined before and after operative treatment. In the postoperative period, reproductive function was realized in a natural way, and also with the help of assisted reproductive technologies. Male factor infertility was excluded. Occurrence of pregnancy was assessed for36 months from the moment of operative treatment. The control group consisted of 60 fertile women without operative intervention on the uterine appendages who had 2 or more children. Results. A moderate decrease of ovarian reserve was diagnosed in patients with endometrioid cysts of the ovaries as compared with the control group. In patients of group 1, a significantly less decrease of ovarian reserve after the operation was noted as compared with patients of group 2. Occurrence of intrauterine pregnancy in groups 1 and 2 was 58% and 36.6%, respectively. The frequency of spontaneous pregnancy in group 1 was 25%, in 2 - 10%. All other intrauterine pregnancies occurred with the help of assisted reproductive technologies. Conclusion. The innovative technique of cystectomy of endometrioid ovarian cysts and assisted reproductive technologies are the most effective methods of treatment of patients with endometrioid ovarian cysts and infertility.