Received May 05, 1997
Accepted September 17, 1997

Introduction:The aim of the current study was to evaluate the efficacy of the treatment of infertile patients with recurrent endometriomas by assisted invasive reproduction after puncturing cystic adnexial masses by ultrasound and prolonged ovary block. Material and Methods:A total of 16 invasive assisted reproduction cycles (IVF or lCSl) were performed in 16 patients aged 32,4±5,2 years with a previous diagnosis of endometrioma and presenting a recurrence at the time of the study. Vaginal puncture guided by ultrasound with subsequent emptying ofthe material was carried out on all endometriomas measuring ≥30 mm. Ovarian block with a GnRH analogue was then started at the dose of 1mg/day or 3,75 mg, at 28 day intervals, for at least 90 days. At the end of this period of blockade, ovarian stimulation was started with highly purified FSH at the dose of 150 to 300 lU/day for 7 days. On day 8 of stimulation, ovarian follicle development was monitored by vaginal ultrasound and the dose of pure FSH was adapted according to the ovarian response of each patent. Standard l VF or lCSl procedures were performed both in the absence and presence of male factor. Results:The number of oocytes collected was 5,62±4,0. The normal fertilization rate was 74±33%, the number of embryos transferred was 2,53±1,1 and the clinical pregnancy rate per puncture was 31,2%. Conclusion:lnfertile patients with recurrent ovarian endometrioma present clinical pregnancy rates per puncture similar to those for patients without ovarian endometriosis after emptying and prolonged ovarian block followed by standard IVF or lCSi.