No difference in cycle pregnancy rate and in cumulative live-birth rate between women with surgically treated minimal to mild endometriosis and women with unexplained infertility after controlled ovarian hyperstimulation and intrauterine insemination

High prevalence of endometriosis in infertile women with normal ovulation and normospermic partners

“…Although the clinical pregnancy rate after ovarian stimulation and IUI has been reported to be lower in women with minimal to mild endometriosis than in women with unexplained infertility, we recently showed that surgical treatment of minimal and mild endometriosis before starting COH and IUI restores the cycle pregnancy rate and reduces the time to pregnancy (6) to the same level as in women with unexplained infertility. However, in a prospective randomized reallocation study evaluating the role of laparoscopy in patients scheduled for IUI (25), the at random allocation of patients with unexplained, cervical, or mild male factor subfertility to IUI or to laparoscopy did not show any difference in pregnancy rates or pelvic pathology with therapeutic implications.…”

“…Although there is a reasonable body of evidence to demonstrate an association between endometriosis and infertility, a causal relation between endometriosis and infertility is likely but remains controversial, especially with respect to minimal or mild endometriosis (1,3,4). Moreover, surgical treatment of endometriosis in infertile women improves their pregnancy rate (5,6).…”

The effect of surgical treatment for endometrioma on in vitro fertilization outcomes: a systematic review and meta-analysis

“…The population studied was either not referred for IVF in 10 series (28)(29)(30)(31)(32)(33)(34)(35)(36)(37) or did not undergo surgical treatment in six (38)(39)(40)(41)(42)(43). Two reports did not meet the inclusion criteria because the study group underwent controlled ovarian hyperstimulation and IUI but not IVF (44,45). The IVF success rates and ovarian response were not demonstrated separately for the group that underwent surgical treatment for endometrioma in three studies (46)(47)(48), and in one study the control group was not defined (49).…”

Stimulated intrauterine insemination (SIUI) and donor insemination (DI) as first line management for a selected subfertile population: the Manchester experience

“…Other authors [25] found similar CLBR for couples who had four attempts of SIUI using either clomiphene citrate or recombinant FSH for ovarian stimulation (26.9% versus 28.2%, respectively). Werbrouck and colleagues [26] reported an equally high CLBR after four cycles of SIUI in couples with unexplained infertility and in women with minimal and mild endometriosis that had been laparoscopically removed before SIUI (66.5%, 70.2% and 68.2%, respectively). It is plausible that variation in the reported effectiveness of IUI could be due to differences in study populations, ovarian stimulation regimens, the number of inseminations per cycle, the timing of insemination and methods of sperm preparation.…”