Cyst aspiration or GnRH antagonist administration for ovarian cysts detected at the start of fresh in vitro fertilization cycles^*

* Oral Presentation at the 2015 Annual Meeting, American Society of Reproductive Medicine, Baltimore, MD, October 17th to 21st 2015.

Abstract

The primary objective of this study is to investigate the effect of transvaginal ultrasonogram (TVUS)-guided cyst aspiration or gonadotropin releasing hormone antagonist (GnRH-ant) administration for the management of solitary ovarian cysts detected at the start of in vitro fertilization (IVF) cycles on the outcomes of the same cycles. This is a single-center, retrospective, cohort study of patients who had TVUS-guided cyst aspiration or GnRH-ant treatment for ovarian cysts detected at the start of IVF during a 5-year period. Four hundred and three patients met inclusion criteria: 41 (10.2%) underwent cyst aspiration and 362 (89.2%) were treated with GnRH-ant. There was no difference in the demographics or baseline IVF cycle characteristics of the two groups. Patients treated with GnRH-ant had a longer duration of ovarian stimulation (10.8 ± 3.45 days versus 9.05 ± 4.06 days, p = 0.003) and required higher gonadotropin doses (3887.7 ± 1097.8 IU versus 3293.7 ± 990.5 IU; p = 0.01) compared with the cyst aspiration group. There was no difference in the clinical pregnancy (43.9% versus 41.4%), spontaneous miscarriage (9.76% versus 8.01%) and live birth (34.1% versus 33.4%) rates between the groups. Our findings suggest that cyst aspiration is comparable to GnRH-ant administration for the management of solitary ovarian cysts detected at the start of IVF cycles.

Chinese abstract

该研究的主要目的是探讨分别使用经阴道超声(TVUS)引导下囊肿抽吸或促性腺激素释放激素拮抗剂(GnRH-ant)治疗在IVF周期开始发现的单侧卵巢囊肿对同一周期结果的影响。这是一项单中心的回顾性队列研究，包含5年中在IVF新鲜周期发现的卵巢囊肿并采用TVUS引导下囊肿抽吸术或GnRH拮抗剂治疗的病人。403名患者符合纳入标准：41(10.2%)人行囊肿抽吸术，362(89.2%)人采用GnRH拮抗剂治疗。两组在人口统计资料或基础IVF周期特征方面比较无差异。与囊肿抽吸组相比，采用GnRH拮抗剂治疗的病人有更长的卵巢刺激持续时间(10.8±3.45天比9.05±4.06天，p=0.003)，需要更高剂量的促性腺激素 (3887.7±1097.8 IU比3293.7±990.5 IU; p=0.01)。两组在临床妊娠率(43.9% 比41.4%)、自然流产率(9.76% 比8.01%)和活产率(34.1%比33.4%)方面比较无差异。我们的研究提示囊肿抽吸与GnRH拮抗剂治疗IVF新鲜周期发现的单侧卵巢囊肿疗效具有可比性。

• Cyst aspiration
• GnRH antagonist
• IVF
• outcomes
• ovarian cyst

Declaration of interest

The authors report no conflicts of interest.

Notes

* Oral Presentation at the 2015 Annual Meeting, American Society of Reproductive Medicine, Baltimore, MD, October 17th to 21st 2015.