Effects of functional ovarian cysts detected on the 7th day of gonadotropin-releasing hormone analog administration on the outcome of IVF treatment

Objective: To investigate the impact of functional ovarian cysts on the tim e required to achieve pituitary suppression, follicular development, embryo quality, and pregnancy rates during IVF treatment. Design: Prospective observational study. Intervention(s): Daily treatment with buserelin (sc 500 mug) was initiated on day 2 of menstruation. Ultrasound and hormonal tests were performed on d ays 1, 7, ii, 14, and weekly thereafter until pituitary suppression was ach ieved. Result(s): 48 patients underwent 51 cycles of IVF treatment. A functional c yst was detected in three cycles (5.8%) with baseline ultrasound scan and i n 27 cycles (52.9%) on day 7 of buserelin administration. Patients who deve loped a cyst required a significantly longer time to achieve pituitary supp ression (21 vs. 7 days), had a significantly lower FSH level at the time of initiation of gonadotropins, required more ampules of gonadotropin (45 vs. 31 ampules), developed less follicles (13 vs. 17.5), and had lower embryo quality. However, there were no differences in the implantation (23.5% vs. 17.2%) and pregnancy rates (37.2% vs. 29.2%) between two groups. Conclusion(s): Functional cysts prolong the period to achieving pituitary s uppression, increase gonadotropin requirements, and decrease follicular rec ruitment and embryo quality. They have, however, no negative effect on preg nancy rates. (Fertil Steril(R) 2000,74.941-5. (C) 2000 by American Society for Reproductive Medicine.)