The effects of ovarian adhesive disease upon follicular development in cycles of controlled stimulation for in vitro fertilization.

This study was designed to determine the effect of periovarian adhesive disease upon follicular development. Forty-one clomiphene citrate/human menopausal gonadotropin/human chorionic gonadotropin-stimulated cycles for in vitro fertilization and embryo transfer were studied. Each patient was assessed ultrasonographically before laparoscopic oocyte recovery. The number of follicles in each ovary greater than 1.2 cm was counted. By laparoscopy it was possible to determine the degree of periovarian adhesive disease. Sixteen patients had bilateral adhesion-free (AF) ovaries, 12 had bilateral adherent (A) ovaries, and 13 had one AF and one A ovary. In the 13 patients with one ovary AF and the other A, the mean number of follicles +/- 1 standard deviation (SD) was 3.4 +/- 1.4 and 1.2 +/- 1.1 (P less than 0.001), respectively. A total of 116 follicles was noted in 45 AF ovaries (mean +/- 1 SD, 2.6 +/- 1.3) and 59 follicles in 37 A ovaries (mean +/- 1 SD, 1.6 +/- 1) (P less than 0.001). From these data it was concluded that the presence of periovarian adhesive disease inhibits folliculogenesis by a yet undetermined mechanism.