Received March 15, 2022
Accepted October 02, 2022

Objective: Endometrioma surgery is associated with a reduction in ovarian reserve. However, removal of endometrioma may increase spontaneous conception chance. The objective of this study is to assess the pre-operative and operative variables affecting spontaneous conception following endometrioma surgery. Methods: Data from 211 women ≤40 years of age who underwent an endometrioma surgery at a university-based infertility clinic between January 2005 and June 2020 were reviewed retrospectively. Main outcome measure was spontaneous clinical pregnancy. 84 women with and 127 women without a successful spontaneous conception formed the case and control groups. Results: The median ages of the case and control groups were 27 and 32 years, respectively (P <0.001). The rate of recurrence was significantly lower in the spontaneous conception group when compared to controls (29.8% vs. 52.8%, respectively; P=0.001). Our results showed no differences in the number, size, or side of the endometriomas in both groups. Multivariate logistic regression analysis showed significant independent effects of age (B: -.166, OR {odds ratio}: 0.847, 95% CI {confidence interval}: 0.791-0.907, P<0.001), recurrence (B: -1.030, OR: 0.357, 95% CI: 0.188-0.678, P=0.002), and laparoscopic surgery rathe rather than laparotomy (B: 1.585, OR: 4.879, 95% CI: 1.029-23.133, P=0.046) for spontaneous conception. Conclusions: The size, number and bilaterality of endometrioma do not affect spontaneous conception chance following surgical removal. However, increasing age and recurrence are negatively associated with the chance of spontaneous conception. Laparoscopic surgery may increase the chance of spontaneous conception when compared to laparotomy.