In vitrofertilization outcomes in patients with advanced endometriosis after surgical treatment

Abstract

ObjectiveThe aim of this study is to evaluate in vitro fertilization (IVF) outcomes in advanced endometriosis with/without surgical treatment and to compare between cyst enucleation and surgically treated peritoneal lesions without endometrioma. MethodsWe performed a retrospective analysis of 506 IVF cycles (345 patients) with stage III-IV endometriosis (170 cycles without surgical treatment, 336 cycles with the surgical treatment) between 1997 and 2004. Among the surgical treatment, 151 cycles were performed previously cyst enucleation with endometrioma and 185 cycles were performed only resection of peritoneal lesions without endometrioma enucleation. 313 cycles (246 patients) with the tubal factor infertility were used as controls. ResultsIn the endometriosis group with/without surgical treatment, the number of retrieved oocytes (9.6±7.3 vs. 11.2 ± 7.5 vs. 14.8 ± 7.0, P < 0.0001) and the transferred embryos (3.5 ± 1.4 vs. 3.5 ± 1.4 vs. 3.9 ± 0.9, P = 0.001) was significantly lower than controls. But, implantation rates (17.2% vs. 15.2% vs. 15.9%), pregnancy rates (36.9% vs. 35.9% vs. 39.6%) and live birth rates (32.1% vs. 28.2% vs. 29.7%) were similar. Surgically treated peritoneal lesions group showed no difference in the number of retrieved oocytes (9.6 ± 7.9 vs. 9.8 ± 6.5), the number of transferred embryos (3.4 ± 1.4 vs. 3.7 ± 1.3), implantation rates (15.5% vs. 18.0%), pregnancy rates (34.6% vs. 39.7%) and live birth rates (29.2% vs. 35.8%) with cyst enucleation group. ConclusionIVF parameters in the patients with endometriosis are inferior to tubal factor infertility, but IVF outcomes are comparable. Surgically treated peritoneal lesions group without endometrioma enucleation shows IVF parameters as bad as cyst enucleation group. We might be considered endometriosis itself worse IVF parameters regardless previous cyst enucleation. Korean J Obstet Gynecol 2011;54(9):517-522 http://dx ORIGINAL ARTICLE

Women with Endometriosis, Especially Those Who Conceived with Assisted Reproductive Technology, Have Increased Risk of Placenta Previa: Meta-analyses

“…The hypermethylation of progesterone receptor ( PR )-B promotor and PR isoform A are also more expressed than PR -B as well as in endometriosis. 23 According to a retrospective analysis by Yang et al, 24 endometriosis itself has worse IVF parameters regardless of previous cyst enucleation. In 2012, Vercellini et al 25 retrospectively assessed pregnancy outcomes in 419 women who achieved a first spontaneous singleton pregnancy following surgery for endometriosis, and stratified the results obtained by endometriosis localization.…”

Serum anti-Müllerian hormone levels in the patients with ovarian endometriosis undergoing surgical treatment

“…자궁내막증은 자궁 내막조직이 골반강에 착상하여 증식하는 여성 생 식기 질환 중 흔한 양성질환으로, 일반 여성에서는 발병률이 0.5%-5% 사이인데 반해, 불임 여성에서는 25%-40%의 비율로 높아 생리통의 원인일 뿐만 아니라 불임과의 연관성이 높은 것을 알 수 있다 [7] [8,9]. 최근 자 궁내막증 환자에서 불임으로 인해 체외수정을 할 때 수술을 받은 환자 군과 수술을 받지 않은 환자군 간에 획득되는 난자수의 감소를 보고하 였고 [10,11], 배란 유도에 대한 반응도가 좋지 않으며 [12][13][14], 성선자극 호르몬 또한 더 많이 필요로 하는 것으로 알려져 있다 [5,15]. 1.36 ± 2.0 vs. 2.68 ± 2.7 ng/mL; P = 0.018) (Fig.…”