***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE Retrospective studies suggest that laparoscopic excision of endometriomas is associated with a reduced responsiveness to ovarian hyperstimulation . In this study , we prospect ively evaluated ovarian response to hyperstimulation in women selected for in vitro fertilization and intracytoplasmic sperm injection cycles who previously underwent laparoscopic enucleation of a monolateral endometrioma . STUDY DESIGN Operated and contralateral intact  ovaries of the same patient were compared in terms of number of follicles , number of oocytes retrieved , fertilization rate , and rate of high- quality embryos . RESULTS Thirty-eight subjects were included . A reduced number of dominant follicles , oocytes , embryos , and high- quality embryos was observed in the operated gonad . The mean percentage of reduction was 60 % ( 95 % confidence interval 38 - 81 % ) , 53 % ( 95 % confidence interval 30 - 75 % ) , 55 % ( 95 % confidence interval 28 - 81 % ) , and 52 % ( 95 % confidence interval 17 - 87 % ) , respectively . Fertilization rate and rate of good- quality embryos were similar . CONCLUSION Laparoscopic excision of endometriomas is associated with a quantitative but not a qualitative damage to ovarian reserve OBJECTIVES Different gonadotropin-releasing-hormone agonist ( GnRH-a ) formulations with different potency and associated side effects , therefore , different compliance and persistence of therapy . This study was to evaluate the difference of hormonal profile and side effects due to hypoestrogenic status after treatment of leuprorelin and triptorelin in Chinese women with ovarian endometrioma after conservative surgical treatment . STUDY DESIGN A total of 302 women underwent laparoscopic excision of ovarian endometriomas with rASRM III and IV were enrolled in the study .Subjects were r and omized into two groups with use of a r and om table . Twenty two patients dropped out during the study . Thus 142 patients had three doses of i.m . leuprorelin ( group A ) and 138 patients had three doses of i.m . triptorelin(group B ) at 4 weeks intervals after surgical treatment . Menopausal symptoms were evalutaed using a question naire and serum sex hormonal levels were also measured during the follow-up . RESULTS At week 4 after the treatment , most of the patients in leuprorelin group have no obvious side effects . After 9 weeks , bone pain , hot flashes and sweating , and irregular bleeding were the main side effects and showed no difference between the groups . Anxiety , depression , vaginal dryness , headache , and acne rates were all significantly higher in triptorelin group than in leuprorelin group . A significant difference in FSH ( p=0.003 ) , LH ( p=0.026 ) and E2 ( p=0.002 ) levels between the groups were observed after 21 days of the GnRHa treatment . The FSH ( p=0.021 ) and E2 ( p=0.033 ) levels remained higher in the leuprorelin group than the triptorelin group after six weeks of treatment , but the difference of LH(p=0.917 ) level was no longer discernible . CONCLUSION Leuprorelin in down-regulating the pituitary-ovarian function was more moderate , and the hormonal levels decrease progressively and gradually , therefore , with lower rate of menopausal symptoms . Leuprorelin acetate maybe better tolerated than triptorelin OBJECTIVE To investigate whether aspiration of ovarian endometriomas before controlled ovarian stimulation ( COH ) improves intracytoplasmic sperm injection ( ICSI ) outcomes . DESIGN Prospect i ve study . SETTING University hospital . PATIENT(S ) A prospect i ve analysis of 171 patients with ovarian endometriosis and tubal factor infertility were divided into four groups : aspiration of endometriomas at the beginning of COH in patients with ovarian endometriomas and no history of previous surgery ( n = 41 ) ( group 1 ) ; nonaspirated endometriomas ( n = 40 ) ( group 2 ) ;  history of ovarian surgery for endometriomas in patients without ovarian endometriomas at the beginning of COH ( n = 44 ) ( group 3 ) ; and  tubal factor infertility ( n = 46 ) ( control group 4 ) . INTERVENTION(S ) Aspiration of endometriomas . MAIN OUTCOME MEASURE(S ) Clinical parameters , characteristics of COH , and ICSI results were analyzed . RESULT ( S ) We observed higher levels of E(2 ) on the day of hCG injection after aspiration of endometriomas compared with nonaspirated endometriomas . When we compared all endometriomas and tubal factor ( control ) groups , we observed a lower number of total follicles ( > 17 mm ) and metaphase II ( MII ) oocytes in nonaspirated and resected endometrioma groups and a longer duration of COH in the nonaspirated endometrioma group compared with the tubal factor group . Implantation and clinical pregnancy rates were similar among all groups . CONCLUSION ( S ) In the current study , all patients with endometriomas had significantly lower numbers of MII oocytes compared with those in patients with tubal factor infertility . We propose that aspiration of endometriomas before COH neither reduces the amount of gonadotropins nor increases the number of follicles > 17 mm , the number of MII oocytes retrieved , the implantation rates , or the clinical pregnancy rates . Resection of small endometriomas ( 1 - 6 cm ) may not present any additional benefits to the IVF-ICSI cycle outcomes OBJECTIVE To assess the impact of prior unilateral or bilateral endometrioma cystectomy  on controlled ovarian hyperstimulation ( COH ) and intracytoplasmic sperm injection ( ICSI ) outcome . DESIGN Retrospective case-control study . SETTING Department of Obstetrics and Gynecology , School of Medicine , Hacettepe University , Ankara , Turkey . PATIENT(S ) Fifty-seven consecutive infertile patients were enrolled who had previously undergone unilateral ( n = 34 ) or bilateral ( n = 23 ) laparoscopic cystectomy for endometriomas more than 3 cm in diameter and underwent ICSI .  The control group consisted of 99 patients with tubal factor infertility . INTERVENTION(S ) Controlled ovarian hyperstimulation and ICSI . MAIN OUTCOME MEASURE(S ) Cycle cancellation rate , number of oocytes , fertilization rate , embryo quality , clinical pregnancy rate ( PR ) , and implantation rate . RESULT ( S ) The mean number of oocytes , metaphase II oocytes , and two-pronucleated oocytes were significantly lower in the bilateral cystectomy group compared to the unilateral cystectomy and control groups . However , all other parameters , including fertilization rate , the mean number of embryos transferred , the mean number of grade 1 embryos transferred , the clinical PR per embryo transfer , and implantation rate , were comparable among the three groups . Within the unilateral cystectomy group , the mean number of oocyte retrieved from the operated site was significantly less than in the contralateral nonoperated site . CONCLUSION ( S ) Laparoscopic endometrioma cystectomy does reduce the ovarian reserve . However , diminished ovarian reserve does not translate into impaired pregnancy outcome Background : Endometriosis is a common hormone-dependent gynecologic disease with a high recurrence . Laparotomy or laparoscopy is the st and ard surgery for the large endometrioma . Also , sclerotherapy is basically used to treat different diseases one of which is endometrioma . Objective : The study was design ed to assess the value of transvaginal ultrasound-guided ethanol sclerotherapy in patients with a recurrent endometrioma . Material s and Methods : In a r and omized clinical trial , an interventional group of 20 patients underwent transvaginal ethanol sclerotherapy for recurrent ovarian endometrioma . The patients were followed up first after one and two weeks and then after one , two , and three months . If the patients had no endometrioma , they were treated with in vitro fertilization ( IVF ) ( st and ard long protocol ) . A control group of 20 patients with endometrioma were enrolled for an IVF protocol . They had no treatment by ethanol sclerotherapy .  IVF parameters , pregnancy rates , and implantation rates were compared in both groups . Results : The demographic data showed no difference between the two groups . The initial mean endometria size was 41.45±15.9 cm , the recurrence rate after 6 months was 4 ( 20 % ) , FSH before and after sclerotherapy was 6.97±2.25 IU/L and 6.78±1.88 IU/L ( p=0.343 ) . The clinical pregnancy rate was 6 ( 33.3 % ) vs. 3 ( 15 % ) , ( p=0.616 ) . The fertilization rate emerged 63.06 % in study group vs. 60.38 % , ( p=0.57 ) . The implantation rate turned out 12.9 % in study group vs. 7.5 % , ( p=0.52 ) . None of these results were significant . However , the data pointed to a better trend toward the ethanol sclerotherapy group . Conclusion : Ethanol sclerotherapy could be an effective strategy for the treatment of recurrent endometrioma especially before IVF Background : Our objective was to evaluate the effect of ovarian endometrioma on ovarian stimulation outcomes in in vitro fertilization cycles ( IVF ) . Material s and Methods : In this prospect i ve cohort study , we followed 103 patients who underwent intra-cytoplasmic sperm injection ( ICSI ) procedures over a 24-months period . The study group consisted of 47 infertile women with either unilateral or bilateral ovarian endometrial cysts of less than 3 cm . The control group consisting of 57 patients with mild male factor infertility was c and i date for ICSI treatment during the same time period as the study groups . Both groups were compared for number of oocytes retrieved , grade s of oocytes , as well as embryo quantity and quality . Results : Our results showed similar follicle numbers , good embryo grade s ( A or B ) and pregnancy rates in the compared groups . However , patients with endometrioma had higher gonadotropin consumption than the control group . The mean number of retrieved oocytes in patients with endometrioma was significantly lower than control group ( 6.6 ± 3.74 vs. 10.4 ± 5.25 ) ( p<0.001 ) . In addition , patients with endometrioma had significantly lower numbers of metaphase II ( MII ) oocytes ( 5 ± 3.21 ) than controls ( 8.2 ± 5.4 ) ( p<0.001 ) . In patients with unilateral endometrioma , there were no significant differences in main outcome measures between normal and involved ovaries in the patients with endometrioma . Conclusion : Patients with ovarian endometrioma had poor outcome . They showed poor ovarian response with lower total numbers of retrieved oocytes and lower MII oocytes during the stimulation phase ; however , it does not affect the total number of embryos transferred per patient , quality of embryos , and pregnancy rate per patient OBJECTIVE To evaluate the effects of laparoscopic cystectomy on ovarian reserve in patients with endometriomas . DESIGN Prospect i ve study . SETTING Private and university hospitals . PATIENT(S ) A total of 193 patients with endometriomas undergoing laparoscopic cyctectomy .  INTERVENTION(S ) Serum levels of antimüllerian hormone ( AMH ) , FSH , and E₂ , as well as antral follicle count ( AFC ) were measured preoperatively and 1 week , 3 and 9 months postoperatively for AMH , and 3 months for other values . MAIN OUTCOME MEASURE(S ) Ovarian reserve based on the comparison of AMH alterations . The secondary end points are changes in FSH , E₂ , and AFC . RESULT ( S ) Serum AMH level decreased significantly from the baseline ( 3.86 ± 3.58 ng/mL ) to 1 week ( 1.66 ± 1.92 ng/mL ) , 3 months ( 2.06 ± 2.5 ng/mL ) , and 9 months ( 1.77 ± 1.76 ng/mL ) postoperatively . Those patients with bilateral endometriomas had significantly lower levels of AMH , 1 week , 3 and 9 months after operation . Also , patients older than 38 years had lower postoperative AMH levels . The FSH levels increased significantly from baseline to 3 months postoperatively . The AFC level increased significantly from baseline to 3 months after operation . CONCLUSION ( S ) The AMH level decreased and the FSH level increased after laparoscopic cystectomy for endometriomas , especially in older patients and those with bilateral cysts OBJECTIVE To determine the difference between two laparoscopic methods for the management of endometriomas with regard to recurrence of signs and symptoms and pregnancy rate . DESIGN Prospect i ve , r and omized clinical trial . SETTING Infertility and gynecologic endoscopy units of two medical university hospitals . PATIENT(S ) One hundred patients with endometriomas who had either infertility or pelvic pain . INTERVENTION(S ) Patients 
    Output:
    
There were no significant differences in pregnancy rate per cycle , clinical pregnancy rate and live birth rate between women who underwent surgery for endometrioma and those who did not .
Conclusion Current evidence suggests that women with endometriosis-related infertility have similar cycle outcomes to other patients going through ART .