Effect of ovarian dermoid cyst excision on ovarian reserve and response: Insights from in vitro fertilization

Abstract

Study objective: To investigate the impact of an ovarian dermoid cyst or dermoid cyst surgery on ovarian reserve in patients undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). Design: We performed a retrospective cohort study by using the records of patients with a history of ovarian dermoid cyst who underwent IVF/ICSI between 2009 and 2013. The antral follicle count (AFC) obtained by transvaginal ultrasound during controlled ovarian hyperstimulation of IVF/ICSI, total number of basal follicles [i.e., basal antral follicle count (B-AFC)], and dominant follicles greater than 1.4 cm [i.e., dominant antral follicle count (D-AFC)] were calculated between the different groups. Patients: We included 260 patients with a history of dermoid cyst excision and 23 patients with a dermoid cyst who underwent IVF/ICSI. Two hundred and eighty-three matched patients without a dermoid cyst and ovarian surgery history were included. Intervention: None. Measurements and main results: The B-AFC was significantly smaller in the dermoid cyst group than in the matched control group (p = 0.030). The B-AFC and D-AFC were both significantly smaller for the previously operated ovary than for the contralateral nonoperated ovary (p = < 0.001), and both were smaller in the ovary with a teratoma than in the other teratoma-free ovary with a mean reduction of 40.5% and 38.8%, respectively (p = 0.018 and p = 0.004, respectively). The B-AFC and D-AFC were significantly fewer in ovaries treated by open surgery than in ovaries treated laparoscopically (p = 0.031 and p = 0.028, respectively). There was no significant difference in the main IVF outcomes between the two groups or the subgroups. Conclusion: Our results suggest that ovarian dermoid cyst excision could significantly reduce ovarian reserve to a similar extent as the cyst itself. The presence or resection of dermoid cysts will not affect the main IVF outcomes.

Keywords

• dermoid cyst
• in vitro fertilization–embryo transfer
• ovarian reserve