Factors affecting clinical outcomes after IVF-ET for infertile young patients with ovarian endometrioma: A 5-year retrospective cohort study

Abstract

This study aimed to compare ovarian reserve function and outcomes after in vitro fertilization and embryo transfer (IVF-ET) for young women with pelvic endometriosis with or without ovarian endometrioma. We explored the main factors influencing pregnancy outcomes in young patients with endometrioma. A total of 619 patients ≤38 years of age who underwent IVF-ET in our reproductive center between January 2011 and December 2015 were recruited. Among these patients, 398 had pelvic endometriosis with ovarian endometrioma and 221 had pelvic endometriosis without ovarian endometrioma. Patients underwent ovulation induction during IVF-ET. The general conditions and clinical outcomes of IVF-ET treatment were compared. Key factors affecting the success of IVF-ET treatment for endometriomas were analyzed. During IVF-ET treatment, the numbers of retrieved oocytes and 2-pronuclei (2PN) embryos in all age groups ( P < .01), and the number of 2PN high-quality embryos in patients under 30 years of age was lower in the pelvic endometriosis with ovarian endometrioma group than in the pelvic endometriosis alone group ( P < .05). Logistic regression analysis showed the number of antral follicles, basal follicle-stimulating hormone (bFSH) levels, number of oocytes, number of 2PN embryos, and number of 2PN high-quality embryos were significantly related to the successful outcome of IVF-ET. Among these, the number of 2PN high-quality embryos was the only independent predictive factor. Ovarian endometrioma significantly impairs ovarian reserve function and ultimately affects the therapeutic efficacy of IVF-ET. Obtaining more 2PN high-quality embryos was important for IVF-ET treatment of young patients with ovarian endometriomas.

Novel predictors for livebirth delivery rate in patients with idiopathic non-obstructive azoospermia based on the clinical prediction model

“…In our study, the number of high-quality embryos and ET-hCG were significantly positively associated with the chance of success. Previous studies reporting the association between an increasing number of high-quality embryos and significantly higher chances of pregnancy after IVF treatment indicate theoretically the positive correlation between the number of high-quality embryos and live birth delivery, which is in agreement with our findings ( 37 ). Studies have reported that endometrial thickness of more than 7–10 mm and 10-12 mm (in frozen-thaw and fresh embryo transfer cycles) and less than 6 mm were associated with increasing and reducing live birth rate respectively ( 38 , 39 ),, which is consistent with our model.…”

Surgical Management of Ovarian Endometrioma: Impact on Ovarian Reserve Parameters and Reproductive Outcomes

“…In a 5-year retrospective study of 619 patients, those with pelvic endometriosis and OMA (N = 398) undergoing IVF-ET had fewer oocytes retrieved and 2-pronuclei embryos in all age groups ( p < 0.01) compared to patients with pelvic endometriosis without OMA. As the number of oocytes and 2-pronuclei embryos were important predictors of IVF-ET success, the authors concluded that the presence of ovarian OMA exerts a negative impact on IVF-ET efficacy [ 86 ].…”

“…OMA per se negatively affects fertility, with an impact on ovarian [ 69 , 70 , 71 ] and, possibly, endometrial level [ 72 , 73 ]. Regarding the impact of unoperated OMA on MAR outcomes, studies have reported contradictory results on response to ovarian stimulation, oocyte and embryo quality, and clinical and livebirth rates [ 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 ]. Cystectomy has, traditionally, been considered superior to non-excisional approaches in terms of chances of spontaneous conception, supported by two RCTs comparing cystectomy to cyst coagulation using bipolar current [ 29 , 30 , 144 , 145 ].…”

Achieving Successful Pregnancy in a Patient With Ovarian Endometriosis Through Assisted Reproductive Technology (ART) Intervention: A Case Report

“…Ovarian endometriosis is found to be present in up to 30%-40% of women with endometriosis [ 7 ]. Research has shown that fibrosis in the ovarian cortex reduces ovarian function and follicles in 55% of women with ovarian endometrioma [ 8 ]. Ovarian endometrioma rarely exceeds 6 cm in diameter.…”

“…Patients with endometriosis who are infertile can successfully increase their pregnancy rate through in vitro fertilization and embryo transfer (IVF-ET). However, compared to other patients, patients with endometriosis had much poorer pregnancy results following IVF-ET [ 8 ].…”