Pregnancy outcome after IVF and ICSI in unexplained, endometriosis-associated and tubal factor infertility.
BACKGROUND
This study was undertaken in order to compare pregnancy outcome after IVF and ICSI in unexplained and endometriosis-associated infertility using tubal factor infertility as controls.


METHODS
This was a retrospective cohort study of early IVF/ICSI pregnancies verified by serum hCG measurement, comparing the subsequent outcome in unexplained (n = 274) and minimal endometriosis-associated (n = 212) with tubal factor (n = 540) infertility as controls. From January 1990 to December 2002, 1026 conception cycles after treatment with IVF or ICSI complied with the inclusion criteria.


RESULTS
Live birth rate, twin birth rate after transfer of two embryos and abortion rate prior to 6 weeks of gestation were superior for the unexplained (78.8, 23.5 and 11.7%) compared to endometriosis-associated (66.0, 15.0 and 19.3%) and tubal factor (66.7, 18.1 and 18.0%) infertility groups (P < 0.05). Compared to the endometriosis-associated, the unexplained infertility group attained a higher pregnancy rate after the first treatment cycle (P < 0.05).


CONCLUSIONS
The overall better outcome for the unexplained infertility group with respect to live birth rate, twin birth rate and early abortion rate compared to the minimal peritoneal endometriosis-associated and tubal factor infertility groups might be a guide to select diagnostic groups for single embryo transfer and be useful in patient counselling.
Omland
Anne K
AK
Department of Obstetrics and Gynaecology, National Hospital, University of Oslo, Sognsvannsveien 20, 0027 Oslo, Norway. anne.omland@rikshospitalet.no
Abyholm
Thomas
T
Fedorcsák
Peter
P
Ertzeid
Gudvor
G
Oldereid
Nan B
NB
Bjercke
Sverre
S
Tanbo
Tom
T
D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D001723:Birth Rate; D015331:Cohort Studies; D004715:Endometriosis / Q000150:complications*; D005184:Fallopian Tube Diseases / Q000150:complications*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D015994:Incidence; D007247:Infertility, Female / Q000209:etiology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic; D014427:Twins