Women with advanced-stage endometriosis and previous surgery respond less well to gonadotropin stimulation, but have similar IVF implantation and delivery rates compared with women with tubal factor infertility.

Abstract

OBJECTIVE:

To investigate the response to controlled ovarian hyperstimulation and ART outcomes in women with advanced-stage endometriosis and previous surgeries at the Yale IVF program between 1996 and 2002.

DESIGN:

Retrospective case control study.

SETTING:

Academic medical center.

PATIENT(S):

The study group consisted of 68 women who previously undergone laparoscopic surgery for advanced-stage endometriosis. The control group included 106 women with tubal-factor infertility. The women with endometriosis underwent 133 IVF-ET cycles and the control group 208 cycles.

INTERVENTION(S):

Controlled ovarian hyperstimulation and IVF-ET.

MAIN OUTCOME MEASURE(S):

Response to gonadotropins, fertilization, cleavage, implantation, pregnancy, miscarriage, and live birth rates.

RESULT(S):

Lower peak E(2) levels, higher total gonadotropin requirements, lower oocyte yield, and higher cancellation rates were found in women with endometriosis compared with tubal-factor control subjects. However, no differences were found in fertilization, cleavage, implantation, pregnancy, miscarriage, and delivery rates between the endometriosis and tubal-factor groups.

CONCLUSION(S):

Women with advanced-stage endometriosis who have undergone previous surgery respond less well to gonadotropins than women with tubal-factor infertility. However, implantation, pregnancy, and delivery rates are similar, suggesting that embryo quality and uterine receptivity remains unaffected despite diminished ovarian reserve in women with endometriosis.

• Authors: Ioannis M Matalliotakis, Hakan Cakmak, Neal Mahutte, Yvoni Fragouli, Aydin Arici, Denny Sakkas
• Journal: Fertility and sterility (Fertil Steril) Vol. 88 Issue 6 Pg. 1568-72 (Dec 2007) ISSN: 1556-5653 [Electronic] United States
• PMID: 17349642 (Publication Type: Comparative Study, Evaluation Study, Journal Article)

Chemical References

• Gonadotropins

Topics

• Adult
• Case-Control Studies
• Delivery, Obstetric
• Embryo Implantation (drug effects)
• Endometriosis (complications, pathology, surgery)
• Female
• Fertilization in Vitro (methods)
• Gonadotropins (therapeutic use)
• Humans
• Infertility, Female (etiology, therapy)
• Ovulation Induction (methods)
• Pregnancy
• Pregnancy Outcome
• Pregnancy Rate
• Retrospective Studies
• Treatment Outcome