Outcome of patients with endometriosis in assisted reproduction: results from in-vitro fertilization and oocyte donation

Abstract

A retrospective analysis of our in-vitro fertilization (IVF) and oocyte donation programmes was carried out in order to gain clinical knowledge of the factors involved in the aetiology of the endometriosis-associated infertility. Comparison between the IVF outcomes from 96 cycles in 78 patients with tubal infertility and from 96 cycles in 59 women with endometriosis indicates that endometriosis patients have a poor IVF outcome in terms of reduced pregnancy rate per cycle (P < 0.0004), reduced pregnancy rate per transfer (P < 0.002), and reduced implantation rate (P < 0.003). The analysis of patients undergoing oocyte donation for different reasons, including low response with or without endometriosis, showed that patients with this disease have the same chances of implantation and pregnancy as other recipients when the oocytes came from donors without known endometriosis. However, when the results of oocyte donation were classified according to the origin of the oocytes donated, patients who received embryos derived from endometriotic ovaries showed a significantly (P < 0.05) reduced implantation rate as compared to the remaining groups. Taken together, all these observations suggest that infertility in endometriosis patients may be related to alterations within the oocyte, which in turn result in embryos with decreased ability to implant.

Tubal transport of gametes and embryos: a review of physiology and pathophysiology

“…At a clinical level, this hypothesis is further supported by studies demonstrating a decreased pregnancy rates when IVF-ET treatment is performed using donated oocytes obtained from women with endometriosis as compared to when oocyte donors did not have endometriosis [90]. Regardless of the causative factor(s) that are responsible for the adverse effects of endometriosis on fertility, surgical treatment of stage I and II endometriosis has been demonstrated to result in a clinically small, but statistically significant, improvement in spontaneous conception following surgery [91,92].…”

Embryo quality before and after surgical treatment of endometriosis in infertile patients

“…Though lower implantation rates in the setting of endometriosis have been reported in multiple clinical studies [13,14], the relative contribution of embryo quality and endometrial receptivity to this finding can be debated. A study by Arici et al [15] found a lower implantation rate in women with endometriosis compared to controls despite similar measures of oocyte/embryo quality, implicating an altered endometrial environment.…”

Endometrial Pinopode and αv 3 Integrin Expression Is Not Impaired in Infertile Patients with Endometriosis

“…In order to investigate this possibility, several studies have been performed on oocyte donor cycles. Thus, in 1994 Simón et al (37) compared oocyte donors who had endometriosis with recipients who had endometriosis and found reduced pregnancy and implantation rates when the oocytes came from donors with endometriosis, but normal rates when only the recipients had endometriosis. In 2000, the same group confirmed this finding in recipients with stage III-IV endometriosis (38).…”